September 2021
Cosela and Libtayo to require prior authorization for URMBT members with a Blue Cross non‑Medicare plan
For dates of service on or after Nov. 1, 2021, the following drugs will require prior authorization through AIM Specialty Health®:
- Cosela™ (trilaciclib), HCPCS code C9078
- Libtayo® (cemiplimab-rwic), HCPCS code J9119
These drugs are covered under the medical benefit.
Prior authorization requirements apply when these drugs are administered in an outpatient setting for UAW Retiree Medical Benefits Trust members with a Blue Cross Blue Shield of Michigan non-Medicare plan.
How to submit authorization requests
Submit prior authorization requests to AIM using one of the following methods:
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 for URMBT members with a Blue Cross non-Medicare plan, see:
Notes:
- Accredo manages prior authorization requests for additional medical benefit drugs.
- The requirements outlined in this article don’t apply to the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714) members.
We’ll update the appropriate drug lists to reflect the information in this message prior to the effective date.
**Blue Cross Blue Shield of Michigan doesn’t own or control this website. |