Management of medical benefit drugs moving from Accredo to Blue Cross for URMBT Blue Cross non-Medicare members

Starting Jan. 1, 2023, Blue Cross Blue Shield of Michigan will manage prior authorizations for additional medical benefit drugs for which Accredo previously managed prior authorizations. You’ll find a list of these drugs later in this article.

This change affects UAW Retiree Medical Benefits Trust Blue Cross non-Medicare members.

These requirements don’t apply:

• When these drugs are administered in an inpatient setting
• To the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714)

How will this change be rolled out?

• For members for whom Accredo approved authorization requests on or before Aug. 31, 2022: Blue Cross will automatically issue a new authorization. These authorizations will be in effect indefinitely. We’ll send letters to notify affected members.
• For members who begin therapies from Sept. 1 through Dec. 31, 2022: Providers don’t need to submit authorization requests. Blue Cross will automatically issue authorizations for the drugs. These authorizations will be in effect indefinitely. We’ll send letters to notify affected members.
• For members who begin therapies on or after Jan. 1, 2023: Providers must submit prior authorization requests to AIM Specialty Health^® or through the NovoLogix^® online tool, as specified in the table below.

How will I submit prior authorization requests starting Jan. 1?

Note: If you need access to Availity^®, follow the instructions on the Register for web tools webpage at bcbsm.com/providers.

What drugs will be affected by this change?

See the list below. For information about additional requirements, such as site of care and quantity limits, see the appropriate drug lists. Access the drug list using the links in the "More about the authorization requirements" section later in this article.

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 Blue Cross non-Medicare plans, see:

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

We’ll update the pertinent drug lists to reflect these changes prior to the effective date.

AIM Specialty Health is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage authorizations for select services. For more information, go to our ereferrals.bcbsm.com website.

Availity is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services.

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