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New Prior Authorization Requirements for HMO, Access Blue, and Blue Choice Plans

Beginning September 1, 2017, prior authorization is required for the medications listed below when administered:

  • In doctor offices
  • By home health care providers
  • By home infusion therapy providers
  • In outpatient hospital and dialysis settings

This change doesn't affect these medications when used in inpatient, surgical day care, urgent care centers, and ER settings. We encourage your employees to discuss this change with their health care provider.

Medications that require prior authorization:

  • Egrifta
  • Exondys-51
  • Gel-Syn
  • Ixinity
  • Kanuma
  • Kovaltry
  • Lemtrada
  • NovoEight
  • Obizur
  • Spinraza
  • Zomacton
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