Blue Cross and BCN to use Audaire Health provider portal to capture clinical outcomes for CAR-T cell therapy drugs

Starting July 1, 2023, Blue Cross Blue Shield of Michigan and Blue Care Network will use the Audaire Health™ provider portal to track and capture clinical outcomes for CAR-T cell therapy drugs for Blue Cross commercial and BCN commercial members.

The data entered in the portal will enable Blue Cross and BCN to capture and assess the clinical benefit of these therapies.

The Audaire portal will replace the manual reporting process for clinical outcomes for CAR-T cell therapy drugs, thereby reducing administrative burden. Blue Cross or BCN will no longer fax forms to prescribing health care providers on an annual basis for them to enter clinical outcome information and send back to us.

Which CAR-T cell therapy drugs are affected? 

Starting July 1, Blue Cross and BCN will require providers to enter clinical outcomes into the Audaire provider portal for the following CAR-T cell therapies, which are covered under members’ medical benefits.

Notes:

• Current requirements will continue to apply to these drugs. Continue to submit prior authorization requests through the NovoLogix^® online tool. (To access NovoLogix, log in to our provider portal, availity.com,** click on Payer Spaces and then click on the BCBSM and BCN logo; this will take you to the Blue Cross and BCN payer space, where you’ll find links to the NovoLogix tools on the Applications tab. If you don’t have access to Availity^®, see the Register for web tools page on bcbsm.com.)
• Providers must enter clinical information in the Audaire provider portal for any additional CAR-T cell therapy drugs approved by the Food and Drug Administration after July 1, 2023.

What will change on July 1?

• The first time Blue Cross or BCN approves your prior authorization request for one of these therapies, you (the requesting provider) must attest that you’ll enter clinical outcome information in the Audaire provider portal. Attestation is required for the therapies to be covered by a member’s benefit. (See How should you prepare for this change? below to learn more about attestation.)
• We’ll automatically add basic information to the Audaire provider portal for members approved for one of these therapies.
• We’ll also add basic information for members approved for one of these therapies from Jan. 1, 2022, through June 30, 2023. An Audaire representative will contact and ask requesting providers to enter clinical outcome information in its provider portal for these members.
• Audaire will send emails on a regular basis to remind providers to submit clinical information. Emails will come from hello@audaire.com, and they’ll include a direct link to the portal for easy access.

Providers can use either of these submission methods:

• Enter clinical information in the easy-to-use survey format in the Audaire provider portal.
• Call 512-643-5099. An Audaire representative will enter the clinical information on your behalf.

Note: Call 512‑643‑5099 to schedule an appointment with an Audaire representative to learn how to enter information in the portal.

How should you prepare for this change?

You don’t need to take action.

The first time Blue Cross or BCN approves your prior authorization request for one of these therapies, an Audaire representative will reach out to you to set up a 30-minute phone call during which they’ll:

• Create your Audaire Health profile, which will complete your attestation.
• Provide training on how to use the portal.
• Answer your questions.

An Audaire representative will also reach out to you if you have patients for whom we approved an authorization request for one of these therapies before July 1 and who have active coverage with Blue Cross or BCN.

Why are we making this change?

CAR-T cell therapies are high-cost treatments, and Blue Cross and BCN recognize the value and therapeutic promise these therapies hold. The goal of collecting this data is to ensure member access to therapies while maintaining affordability.

Do other drugs require tracking in the Audaire provider portal?

Blue Cross and BCN also require providers to track clinical outcomes for commercial members for the following high-cost spinal muscular atrophy therapies:

• Zolgensma^® (onasemnogene abeparvovec-xioi)
• Spinraza^® (nusinersen)
• Evrysdi^® (risdiplam)

For additional details, see the October 2022 Record article and the November-December 2022 BCN Provider News article.

Questions?

Email questions to Allison Olmsted, Pharm.D., at aolmsted@bcbsm.com.

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

Audaire Health is a contracted independent company that provides select services to Blue Cross and BCN commercial members.

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