Jemperli™ and Zynlonta™ require prior authorization for dates of service on or after July 26, 2021, for most members
For dates of service on or after July 26, 2021, we're adding prior authorization requirements for the following drugs covered under the medical benefit:
Submit prior authorization requests through AIM Specialty Health®.
Prior authorization requirements apply when these drugs are administered in outpatient settings for:
Exceptions: The Blue Cross commercial requirements don't apply to members who have coverage through Michigan Education Special Services Association or the Blue Cross and Blue Shield Federal Employee Program®, or to UAW Retiree Medical Benefits Trust non-Medicare members.
How to submit authorization requests
Submit authorization requests to AIM using one of the following methods:
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. As always, 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:
We'll update the appropriate drug lists to reflect the information in this message prior to the effective date.
*Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're not responsible for its content.
Posted: May 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network