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Pharmacy Medical Policy Updates

The following Pharmacy Medical Policy programs have been updated Dec. 1, 2021:

Effective Jan. 1, 2022:

  • Coverage Exception HIM
  • Health Care Provider Administered (HCPA) Biologic Immunomodulator
  • Cholestasis Pruritus
  • Kerendia
  • Human Fibrinogen Concentrate
  • Hemophilia Factor VIII
  • Hemophilia Factor IX
  • Coagulation Factor VIIa
  • Coagulation Factor X
  • Isturisa
  • Natpara
  • Continuous Glucose Monitoring Systems (CGM) 

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