Sarclisa^® will require prior authorization starting May 15 for BCN HMO^SM, Medicare Plus Blue^SM PPO and BCN Advantage^SM members

We're expanding the prior authorization program for specialty drugs covered under the medical benefit for BCN HMO, Medicare Plus Blue and BCN Advantage members.

For dates of service on or after May 15, 2020, Sarclisa (isatuximab-irfc, HCPCS code J3490, J3590, J9999) will require authorization through AIM Specialty Health^®.

How to submit authorization requests

For this drug, submit authorization requests to AIM using one of the following methods:

• Through the AIM provider portal*
• By calling the AIM Contact Center at 1-844-377-1278

For information about registering for and accessing the AIM ProviderPortal, see the Frequently asked questions page* on the AIM website.

More about the authorization requirements

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

For additional information on requirements related to drugs covered under the medical benefit, see:

• BCN HMO: Blue Cross and BCN utilization management medical drug list (PDF)
• BCN HMO: Medical Oncology Program (PDF) list
• Medicare Advantage: Medical Drug and Step Therapy Prior Authorization List for Medicare Plus Blue PPO and BCN Advantage members (PDF)

We'll update the requirements lists with the new information about Sarclisa prior to May 15.

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