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May 2022

Brineura won’t require prior authorization for URMBT members with Blue Cross non-Medicare plans

In December 2021, we communicated that we’d be adding a prior authorization requirement for Brineura® (cerliponase alfa), HCPCS code J0567, for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, starting March 10, 2022.

However, URMBT has decided not to add Brineura as a benefit for Blue Cross Blue Shield of Michigan non-Medicare plans. As a result, we updated the NovoLogix® online tool to remove prior authorization and quantity limit requirements for Brineura for these members.

For information on requirements related to drugs covered under the medical benefit, refer to the document titled Medical Drug Management with Blue Cross for UAW Retiree Medical Benefit Trust PPO non-Medicare members.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.