Medical specialty drug prior authorization list will change in January for Blue Cross commercial fully insured groups

For dates of service on or after Jan. 18, 2021, we’re adding prior authorization requirements for the following specialty drugs covered under the medical benefit for Blue Cross Blue Shield of Michigan commercial fully insured groups, with the exception of the Michigan Education Special Services Association and the Blue Cross and Blue Shield Federal Employee Program^®:

• Blenrep (belantamab mafodotin-blmf), HCPCS codes J3490, J3590, J9999, C9399
• Monjuvi™ (tafasitamab-cxix), HCPCS codes J3490, J3590, J9999, C9399

Providers must request prior authorization for these drugs through AIM Specialty Health^®.

How to submit authorization requests

Submit authorization requests to AIM using one of the following methods:

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

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

More about 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 the Blue Cross and BCN utilization management medical drug list and the Medical oncology prior authorization list.

We’ll update these lists to reflect these changes prior to the effective dates.

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