Some medical drugs no longer require authorization for BCN AdvantageSM members

Authorization is no longer required for BCN Advantage members for the following drugs covered under the medical benefit:

For a full list of all drugs covered under the medical benefit that require authorization, along with their procedure codes, refer to the BCN Referral and Clinical Review Program, available on this website.

Details on medical necessity criteria are also available on this website. Click Clinical Information for Drugs Covered under the Medical Benefit That Require Medical Necessity Review.

Both of these documents will be updated with the changes outlined in this news item. The revised documents will be available on this website, on the Clinical Review & Criteria Charts page, at the end of June.

Posted: May 2016
Line of business: Blue Care Network