BCBS Nebraska Medical Policy Updates – December 2018

Click here to view the Blue Cross Blue Shield Nebraska Medical Policy Updates »

 December 2018 BCBS Nebraska Medical Policy Updates:

• Adynovate
• Airduo  (Preauthorization Required)
• Angiotensin Converting Enzyme Inhibitors & Angiotensin Receptor Blockers (Requires Preauthorization)
• Biologics For Gastrointestinal Disease (Requires Preauthorization)
• Biologics For Plaque Psoriasis (Requires Preauthorization)
• Brigatinib/Alunbrig   (Preauthorization Required)
• Cholbam (Requires Preauthorization)
• Cosmetic And Reconstructive Surgery (Preauthorization Recommended)
• Diabetic Glucose Test Strips (Requires Preauthorization)
• Disease Modifying Therapies For Multiple Sclerosis (Requires Preauthorization)
• Duchenne Muscular Dystropy (Preauthorization Required)
• Dupixent (Requires Preauthorization)
• Elaprase™ / Idursulfase (Requires Preauthorization)
• Epinephrine (Preauthorization Required)
• Etelcalcetide (Parsabiv)  (Preauthorization Requried)
• Exulizumab/Soliris  (Preauthorization Required)
• Glumetza
• Hetlioz (Tasimelteon) (Requires Preauthorization)
• Intravenous Immune Globulin (Requires Preauthorization)
• Krystexxa/ Pegloticase (Requires Preauthorization)
• Magnetic Resonance Neurography (Requires Preauthorization)
• Medications To Treat Cryopyrin Associated Periodic Syndromes (Caps) (Requires Preauthorization)
• Methylergonovine (Methergine) For Migraine Prophylaxis  (Preauthorization Required)
• Myalept (Metreleptin) (Requires Preauthorization)
• Natpara (Requires Preauthorization)
• Northera/Droxidopa (Requires Preauthorization)
• Olaparib (Lynparza) (Requires Preauthorization)
• Omalizumab/Xolair (Requires Preauthorization)
• Otezla (Preauthorization Required)
• Oxycontin Quantity Limits (Requires Preauthorization)
• Palbociclib (Ibrance) (Requires Preauthorization)
• Palivizumab / Synagis® (Requires Preauthorization)
• Procedures Recommended For Medical Necessity Review (Requires Preauthorization)
• Progesterone Therapy As A Technique To Reduce Preterm Birth In High-Risk Pregnancies (Preauthorization Required)
• Prolia/ Denosumab (Requires Preauthorization)
• Proton Pump Inhibitors (Requires Preauthorization)
• Quantity Limit Program (Requires Preauthorization)
• Qutenza/ Capsaicin 8% Patch (Requires Preauthorization)
• Radicava/Edaravone  (Preauthorization Required)
• Ribociclib (Kisqali)  (Preauthorization Required)
• Sedative Hypnotics (Requires Preauthorization)
• Spinal Cord Stimulator (Preauthorization Required)
• Teduglutide (Gattex®) (Requires Preauthorization)
• Topical Acne Agents (Requires Preauthorization)
• Topical Doxipen
• Treatment For Idiopathic Pulmonary Fibrosis (Requires Preauthorization)
• Um Netresults  (Preauthorization Required)
• Uptravi
• Vertebroplasty/Kyphoplasty (Preauthorization Required)
• Xermelo/Telotristal Ethyl  (Preauthorization Required)
• Zelula  (Preauthorization Required)
• Ziv-Aflibercept/Zaltrap (Requires Preauthorization)
• Hereditary Amyloidosis Products (Preauthorization Required)
• Nucala, Cinqair & Fasenra (Requires Preauthorization)
• Self-Administered Oncology Agents (Require Preauthorization)

Click here to view the Blue Cross Blue Shield Nebraska Medical Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. When reviews occur out of cycle they often go unnoticed. Policy Alerts keeps you updated when Payers make coverage changes to medical policies affecting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on medical Insurance decisions in real-time. When changes occur, instant email alerts are delivered to your inbox. Clients have access to detailed coverage reports and medical policies through the interactive Policy Alerts Dashboard portal. Save time each month and keep focused on important Payer medical policy reviews and coverage decisions affecting your business!

Policy Alerts takes a client-focused hands-on approach and is constantly working to provide our customers with helpful insights and actionable analytics. We understand what our clients need and are dedicated to providing timely, accurate, and always up-to-date reports.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.