Additional drugs to require prior authorization for URMBT members with Blue Cross non‑Medicare plan

For dates of service on or after Nov. 1, 2021, we’re adding prior authorization requirements for the following drugs covered under the medical benefit:

• Abecma^® (idecabtagene vicleucel), HCPCS code J3590
• Breyanzi^® (lisocabtagene maraleucel), HCPCS codes J3590, C9076
• Beovu^® (brolucizumab-dbll), HCPCS code J0179
• Tepezza^® (teprotumumab-trbw), HCPCS code J3241
• Onpattro^® (patisiran), HCPCS code J0222

Submit prior authorization requests through the NovoLogix^® online tool.

Prior authorization requirements apply when these drugs are administered in an outpatient setting for UAW Retiree Medical Benefits Trust, or URMBT, members with a non-Medicare plan.

How to submit authorization requests

Submit prior authorization requests through NovoLogix. It offers real-time status checks and immediate approvals for certain medications.

To learn how to submit requests through NovoLogix, do the following:

1. Go to ereferrals.bcbsm.com.
2. Click on Blue Cross.
3. Click on Medical Benefit Drugs.
4. Scroll to the Blue Cross commercial column.
5. Review the information in the How to submit requests electronically using NovoLogix section.

More about the authorization requirements

Authorization isn’t a guarantee of payment. As always, health care practitioners need to verify eligibility and benefits for members.

For additional information on requirements related to drugs covered under the medical benefit for URMBT members with a Blue Cross non-Medicare plan, see:

• Medical Drug Management with Blue Cross for UAW Retiree Medical Benefit Trust PPO non-Medicare Members
• Medical oncology prior authorization list for UAW Retiree Medical Benefits Trust PPO non-Medicare members

Note: Accredo manages prior authorization requests for the URMBT for select medical benefit drugs that aren’t included on these two lists.

We’ll update the appropriate drug lists to reflect the information in this message before the effective date.