Cosela^™ and Libtayo^® to require prior authorization for Blue Cross URMBT non-Medicare members, starting Nov. 1

For dates of service on or after Nov. 1, 2021, the following drugs will require prior authorization through AIM Specialty Health^®:

• Cosela (trilaciclib), HCPCS code C9078
• Libtayo (cemiplimab-rwic), HCPCS code J9119

These drugs are covered under the medical benefit.

Prior authorization requirements apply when these drugs are administered in an outpatient setting for Blue Cross UAW Retiree Medical Benefits Trust non-Medicare members.

How to submit authorization requests

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

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

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 Blue Cross URMBT non-Medicare members, see:

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

Note: Accredo manages prior authorization requests for additional medical benefit drugs.

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

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Posted: August 2021
Line of business: Blue Cross Blue Shield of Michigan