For Blue Cross' PPO (commercial) and BCN HMOSM (commercial) members, ketoprofen 25 mg will require authorization and have new quantity limits
The following changes are coming for Blue Cross' PPO (commercial) and BCN HMO (commercial) members:
Members who start taking ketoprofen prior to Dec. 1, 2019, can continue their treatment courses. However, as of March 1, 2020, you'll need to obtain authorization for these members to continue therapy.
For treatment courses starting on or after Dec. 1, 2019, you'll need to obtain authorization before members begin taking ketoprofen.
We'll notify affected members of these changes, and we'll encourage them to talk to you if they have concerns.
Authorization isn't a guarantee of payment. Health care providers need to verify eligibility and benefits for members.
Note: These requirements don't apply to Medicare Plus BlueSM PPO or BCN AdvantageSM members.
Posted: October 2019
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network