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Pharmacy Medical Policy Updates

The following Pharmacy Medical Policy programs were updated April 1, 2024:

Effective May 1, 2024:

  • Healthcare Administered Multiple Sclerosis
  • Multiple Sclerosis
  • Hereditary Angioedema (HAE)
  • Opioids ER
  • Risdiplam
  • Spinraza
  • Site of Care 
  • VMAT2 Inhibitors
  • Xhance
  • PAH (formerly Oral PAH)
  • Skyclarys
  • Xphozah

Many of our pharmacy medical policies are maintained through our pharmacy benefit manager, Prime Therapeutics.

To find pharmacy medical policies specific to a medication list, please select a medication list at the bottom of our prior authorization page of our website, https://www.bcbsks.com/providers/precertification-prior-authorization

If you have any questions regarding this newsletter, please contact your BCBSKS provider representative/consultant.

Institutional Providers
Professional Providers