Blue Cross and Blue Shield of North Carolina Expands Specialty Pharmacy Precertification List

Please note, this communication applies to Healthy Blue + Medicare^SM (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina.

Effective on and after January 1, 2022, the specialty Medicare Part B drugs listed in the table below will be included in our precertification review process.

Federal and state law, as well as state contract language and Centers for Medicare and Medicaid Services guidelines — including definitions and specific contract provisions/exclusions — take precedence over these precertification rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.

https://www.bluecrossnc.com/providers/blue-medicare-providers/healthy-blue-medicare

BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is an independent licensee of the Blue Cross and Blue Shield Association. All other marks are the property of their respective owners.
BNCCARE-0202-21 September 2021 519441MUPENMUB