CommercialPrior AuthMedium impact
MDR Drug Addition— Avastin 1/1/19
Blue Cross Blue Shield of Rhode Island·RI · Oncology·Physician / Behavioral Health
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
Effective January 1, 2019, BCBSRI requires prior authorization for Avastin (bevacizumab) when used for oncology diagnoses under the medical benefit for Commercial products only. Medicare Advantage products are not affected by this change at this time.
Action Required
By January 1, 2019: Billing team must update prior authorization requirements for Avastin (bevacizumab) oncology treatments covered under medical benefit for BCBSRI Commercial plans only. Contact Prime Therapeutics at 1-844-765-2892 for prior authorization assistance. Update encounter forms to remind oncology providers that PA is required for existing patients (continuity of care will be considered). Claims without prior auth will be denied.