Sarclisa requires prior authorization for Medicare Plus Blue PPO, BCN Advantage and BCN HMO members

We recently expanded the prior authorization program for specialty drugs covered under the medical benefit for Medicare Plus Blue^SM, BCN Advantage^SM and BCN HMO^SM members.

For dates of service on or after May 15, 2020, Sarclisa^® (isatuximab-irfc, HCPCS codes J3490, J3590 and J9999) requires authorization through AIM Specialty Health^®.

How to submit authorization requests
For this drug, submit authorization requests to AIM using one of the following methods:

• Through the AIM ProviderPortal**
• By calling the AIM Contact Center at 1-844-377-1278

For information about registering for and accessing the AIM ProviderPortal, see Frequently asked questions.**

More about the authorization requirements
Authorization isn’t a guarantee of payment. Health care practitioners need to verify eligibility and benefits for members.

For additional information on requirements related to drugs covered under the medical benefit, see:

• Medicare Advantage: Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue PPO and BCN Advantage members
• BCN: Blue Cross and BCN utilization management medical drug list and Medical Oncology Program list

We’ve updated the requirements lists with the new information about Sarclisa.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.