Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will apply the following new requirements to our pharmacy utilization management for the below listed drugs. These changes will be effective April 1, 2022.
Our utilization management requirements apply to all commercial members with pharmacy benefit coverage through Blue Cross NC. These changes will not apply to the following lines of business: State Health Plan, Federal Employee Program, Medicare Part D members, or any self-funded employer groups that carve out pharmacy benefits to another pharmacy benefits manager (PBM).
New Requirements