CommercialCoverageMedium impact
July 1, 2021 formulary changes – Net Results Plus update
Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
Jul 1, 2021
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated their Net Results Plus formulary effective July 1, 2021, excluding coverage for multiple brand name drugs with generic equivalents, moving several medications to higher copay tiers, and requiring prior authorization for Xhance and Sucraid. Generic alternatives will continue to be covered for excluded brand medications.
Action Required
By July 1, 2021: Billing and clinical teams must update prescription practices to use generic equivalents for excluded brand medications (Alinia, Atripla, Banzel, etc.), obtain prior authorization for Xhance and Sucraid before prescribing, and inform patients of higher copays for tier-changed medications like Flurbiprofen and Oxycodone/Acetaminophen. Update EMR alerts to flag these formulary changes to prevent claim denials.