Please note, this communication applies to Healthy Blue + Medicare℠ (HMO-POS D-SNP) offered by Blue Cross and Blue Shield of North Carolina.
Effective for dates of service on and after August 1, 2024, 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 CMS 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.
