We're removing zoledronic acid drugs from the Medicare Part B medical specialty drug prior authorization list in March

We're removing medications from the Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue^SM PPO and BCN Advantage^SM members. These specialty medications are administered in outpatient sites of care, a physician's office, an outpatient facility or a member's home.

For dates of service on or after March 2, 2020, the following medications for osteoporosis, bone metastases due to solid tumors and other diagnoses involving bone health will no longer require authorization:

• J3489 zoledronic acid (Reclast^®, Zometa^®)

Important reminder

NovoLogix allows you to quickly submit authorization requests. It offers real-time status checks and immediate approvals for certain medications. Also note:

• For Medicare Plus Blue, if you have a Type 1 (individual) NPI and you checked the "Medical Drug PA" box when you completed the Provider Secured Services Application form, you already have access to NovoLogix. If you didn't check that box, you can complete an Addendum P form to request access to NovoLogix and fax it to the number on the form.
• For BCN Advantage, if you have access to Provider Secured Services, you already have access to enter authorization requests through NovoLogix.

If you need to request access to Provider Secured Services, complete the Provider Secured Access Application form and fax it to the number on the form.

List of requirements

For a list of requirements related to drugs covered under the medical benefit, please see the Medical Drug and Step Therapy Prior Authorization List.

Posted: January 2020
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network