Effective July 1, no authorization is required for multiple sclerosis medications for Blue Cross, BCN commercial members
Effective for dates of service on or after July 1, 2018, multiple sclerosis medications covered under the medical benefit will not require authorization, for Blue Cross PPO (commercial) and BCN HMOSM (commercial) members. This change applies to the following medications:
| Brand name | Generic name | HCPCS code |
|---|---|---|
| LemtradaTM | alemtuzumab | J0202 |
| OcrevusTM | ocrelizumab | J2350 |
| Tysabri® | natalizumab | J2323 |
For Blue Cross and BCN commercial members with an active authorization for one of these medications, no additional action is required by the member or the provider.
This change does not apply to BCN AdvantageSM, Blue Cross Medicare Plus BlueSM PPO or Federal Employee Program® members. The requirements for these products are as follows:
- For BCN Advantage and Federal Employee Program members, no authorization is currently required.
- For Medicare Plus Blue members, authorization is currently required and will continue to be required.
For additional information on the change related to commercial members, look for articles in the following upcoming newsletters:
- May 2018 issue of The Record
- May-June 2018 issue of BCN Provider News
Posted: April 2018
Line of business: Blue Care Network