Reblozyl^® will have authorization and site-of-care requirements for commercial members effective February and April 2020

We're adding authorization and site-of-care requirements for specialty drugs covered under the medical benefit to include Reblozyl (luspatercept-aamt, HCPCS code J3590) for commercial members:

• For BCN HMO^SM (commercial) members: Reblozyl will require authorization and have site-of-care requirements for members who begin therapy on or after Feb. 1, 2020.

• For Blue Cross' PPO (commercial) members: Reblozyl will require authorization for members who begin therapy on or after April 2, 2020.

More about the authorization requirements

The authorization requirements apply only to groups that are currently participating in the standard commercial Medical Drug Prior Authorization Program for drugs administered under the medical benefit. These changes don't apply to members covered by the Federal Employee Program^® Service Benefit Plan.

Authorization isn't a guarantee of payment. Health care practitioners need to verify eligibility and benefits for members.

List of requirements

For a list of requirements related to drugs covered under the medical benefit, please see the Requirements for drugs covered under the medical benefit - BCN HMO and Blue Cross PPO document located on the following pages of this website:

• The Blue Cross Medical Benefit Drugs - Pharmacy webpage
• The BCN Medical Benefit Drugs - Pharmacy webpage

We'll update the requirements list for the drug listed above prior to the effective dates for the changes.

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