Skip to main content
Shop Plans Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Get Started Individual & Family Medicare Employer Vision Dental International Travel Find Care FAQ Blog Members Stay on top of your health care with helpful member resources. Members Home Medicare Health Dental Vision Find Care Member Knowledge Center Member Forms Medicare Forms Library Make a Payment Federal Employees Student Blue Healthy Blue Providers Access tools, policies and the latest information to help you care for our members. Providers Home Network Participation Networks & Programs Claims, Appeals & Inquiries Prior Authorization Services & CPT codes Prescription Drug Search Policies, Guidelines & Codes Provider News Provider FAQ Contact Us Employers Learn about our coverage options for small and large employers, and access tools and resources for your group. Employers Home Shop Employer Plans Employer Portal Support Member Forms & Resources Find Care Blog Agents Access the tools you need: rate quotes, applications, forms, the latest industry news, marketing materials and more. Agents Home Agent Services Check Eligibility Find Care Member Forms & Resources Medicare Forms Library
Contact Us
Log In
I am ... Please select A member A provider An employer An agent
Log in to Agent Services
Log in to Employer Services Register for Employer Services I'm registered but need portal access
Username Forgot username? Continue to Log In Register for Blue Connect Need help? Learn how to log in.
Log in to Blue e Register for Blue e Log in to Dental Blue
Back
Notification of Drug Policy Revisions Effective January 1, 2023 (Posted November 1, 2022) November 01, 2022
Medical Drug Policy NameRevised Criteria
Abatacept (Orencia®)Changed requirement for trial and failure of preferred agents for rheumatoid arthritis and psoriatic arthritis to include both an infliximab product AND Simponi Aria. Policy notification given 11/1/2022 for effective date 1/1/2023.
Betibeglogene autotemcel (Zynteglo®) Added distribution channel restriction language to policy. Adjusted formatting and defined authorization length for clarity with no change to policy intent. Policy notification given 11/1/2022 for effective date 1/1/2023.
Interleukin-5 Antagonists Added requirement within initial criteria for asthma indication that patient must be adherent to conventional therapies. Corrected typographical, formatting, and criteria errors within policy for CRSwNP indication with no change to policy intent. Policy notification given 11/1/2022 for effective date 1/1/2023.
Intra Articular Hyaluronan Injections for Treatment of Osteoarthritis of the KneeChanged requirement for trial and failure of preferred agents from Synvisc or Synvisc-One AND Durolane or Gelsyn-3 to Synvisc or Synvisc-One AND Orthovisc. Policy notification given 11/1/2022 for effective date 1/1/2023.
Omalizumab (Xolair®) Added requirement within initial criteria for asthma indication that patient must be adherent to use of a medium dose inhaled corticosteroid with combination therapy. Minor formatting adjustments made to policy. Policy notification given 11/1/2022 for effective date 1/1/2023.
Tezepelumab-ekko (Tezspire™)Added requirement within initial criteria that patient must be adherent to use of conventional asthma control therapies. Policy notification given 11/1/2022 for effective date 1/1/2023.
Tocilizumab (Actemra®) Changed requirement for trial and failure of preferred agents for rheumatoid arthritis to include both an infliximab product AND Simponi Aria. Policy notification given 11/1/2022 for effective date 1/1/2023.