Discontinuation of Inpatient Review of Injectable Oncology Drugs

Effective June 16, 2021, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will no longer require prior plan approval in the inpatient setting for injectable oncology drugs billed under the medical benefit. There is no negative impact to members or providers as these drugs will no longer require prior approval in the inpatient setting. This change will help provide more efficient care for members receiving these treatments in the inpatient setting.

Actions for Providers

Following June 16, 2021, providers will no longer need to submit prior approval requests in the inpatient setting for injectable oncology drugs billed under the medical benefit. Please continue to visit our Medical Policy site if there are questions about which drugs require prior plan approval.

These changes apply to the following lines of business: Administrative Services Only (ASO), fully insured membership, Blue Card IPP Host and the State Health Plan (SHP).