
September 2023
Starting Oct. 1, 2023, we’ll change prior authorization criteria for some weight loss drugs (PDF)
New and updated questionnaires in the e-referral system starting Sept. 24 (PDF)
Prior authorization no longer required for some procedures, starting Jan. 1 (PDF)
Daxxify to require prior authorization for Medicare Advantage members starting Dec. 18 (PDF)
e-referral system out of service for maintenance overnight Sept. 16-17 (PDF)
Zynyz to require prior authorization for most members starting Dec. 10 (PDF)
Lumoxiti will no longer require prior authorization starting Sept. 30 (PDF)
Update: Advance notice requirements for noncovered services by independent and hospital labs (PDF)
Updated Orthoptic and pleoptic visual training questionnaire in e-referral system (PDF)
Tyruko to require prior authorization for most commercial members starting Sept. 14 (PDF)
August 2023
Medicare Plus BlueSM PPO Provider Manual update coming in October 2023 (PDF)
Veopoz, Eylea HD and Daxxify to require prior authorization for most commercial members (PDF)
Sept. 4 holiday closure: How to submit inpatient authorization requests (PDF)
Prior authorization changes for varicose vein treatments (PDF)
New and updated questionnaires in the e-referral system starting Aug. 27 (PDF)
Requirements for prior authorization of Omisirge (PDF)
Lantidra and Rethymic to require prior authorization for most commercial members (PDF)
Starting Sept. 1, we’ll require prior authorization for some diabetes drugs (PDF)
Izervay to require prior authorization for most commercial members (PDF)
e-referral system out of service for maintenance overnight Aug. 19-20 (PDF)
July 2023
Update: Changes for in-lab sleep studies to start Oct. 9 (PDF)
Updated questionnaires in the e-referral system (PDF)
For commercial LTACH requests, submit information about three SNFs to avoid delays (PDF)
Rystiggo® and Vyvgart® Hytrulo to require prior authorization for most commercial members (PDF)
e-referral system out of service for maintenance overnight July 15-16 (PDF)
June 2023
July 3-4 holiday closure: How to submit inpatient authorization requests (PDF)
Updated Septoplasty and Blepharoplasty questionnaires in the e-referral system (PDF)
June 19 holiday closure: How to submit inpatient authorization requests (PDF)
How Blue Cross and BCN are handling authorizations for Makena® following FDA announcement (PDF)
Updated Left atrial appendage closure questionnaires in the e-referral system (PDF)
e-referral user guides updated (PDF)
Carelon to expand existing prior authorization program starting Sept. 1 (PDF)
We’ll use 2023 InterQual® criteria starting Aug. 1 (PDF)
May 2023
Vyjuvek™ to require prior authorization for most commercial members (PDF)
Elfabrio® and Omisirge® to require prior authorization for most commercial members (PDF)
e-referral system unavailable on three May-June weekends (PDF)
QalsodyTM to require prior authorization for Medicare Advantage members starting Aug. 1 (PDF)
Updated questionnaires in the e-referral system, starting May 14 (PDF)
Updated medical record documentation guidelines for musculoskeletal procedures (PDF)
Learn how to submit requests for ABA services through e-referral (PDF)
Updates to list of musculoskeletal procedure codes that require prior authorization (PDF)
QalsodyTM to require prior authorization for most commercial members (PDF)
Some pre-COVID-19 utilization management requirements to resume July 1 (PDF)
e-referral system out of service on two weekends in May (PDF)
April 2023
Starting June 1, submit prior authorization requests for ABA services through e-referral (PDF)
Quartet Care Navigation Platform: FAQ for behavioral health providers is available (PDF)
Updated questionnaires in the e-referral system, starting April 24 (PDF)
Changes to maternity support program and new menopause support program (PDF)
Updated questionnaire in the e-referral system (PDF)
TzieldTM to require prior authorization for URMBT members with Blue Cross non-Medicare plans (PDF)
e-referral system out of service for maintenance overnight April 15-16 (PDF)
March 2023
April 7 holiday closure: How to submit inpatient authorization requests (PDF)
RolvedonTM will have requirements for URMBT members with Blue Cross non-Medicare plans (PDF)
Prior authorization processes for MESSA members changing June 1 (PDF)
AIM to change its name to Carelon (PDF)
Questionnaire changes in the e-referral system (PDF)
Lamzede® to require prior authorization for Medicare Advantage members starting May 1 (PDF)
BriumviTM to have a site-of-care requirement for most commercial members starting July 1 (PDF)
e-referral system out of service for maintenance overnight March 18-19 (PDF)
Resources for members coping with the MSU tragedy (PDF)
Changes to Carelon’s (formerly AIM’s) provider portal for medical oncology program (PDF)
Updated: Prior authorization changes coming in June (PDF)
Members may call about colorectal cancer screening (PDF)
February 2023
Determining prior authorization requirements for patients with non-Michigan Blue plans (PDF)
Lamzede, Syfovre™ and Vegzelma® to require prior authorization for most commercial members (PDF)
Syfovre™ to require prior authorization for Medicare Advantage members starting April 3 (PDF)
Behavioral health resources needed for members (PDF)
e-referral system out of service for maintenance overnight Feb. 18-19 (PDF)
Adstiladrin® to require prior authorization for Medicare Advantage members starting May 1 (PDF)
Questionnaires available again in the e-referral system (PDF)
AIM ProviderPortal operating slowly (PDF)
January 2023
RebyotaTM to require prior authorization for Medicare Advantage members starting March 1 (PDF)
e-referral system out of service for maintenance overnight Jan. 21-22 (PDF)
Byooviz® is no longer the preferred ranibizumab drug for Medicare Advantage members (PDF)
Leqembi™ to require prior authorization for Medicare Advantage members starting Jan. 13 (PDF)
Jan. 16 holiday closure: How to submit inpatient authorization requests (PDF)