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Pharmacy Policy Updates

Blue Cross Blue Shield of North Dakota·ND · Oncology, Hematology, Rheumatology +5 more·Pharmacy
Effective date
Jun 1, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

Blue Cross Blue Shield of North Dakota is implementing new prior authorization requirements for two Medicaid Expansion medical drugs (Donanemab and Zopapogene Imadenovec-drba) and revising prior authorization policies for 38 existing medical drugs including specialty cancer, autoimmune, and rare disease treatments.

Action Required

Action needed
By June 1, 2026: Billing and authorization teams must update prior authorization workflows for Medicaid Expansion patients receiving Donanemab (Kisunla) and Zopapogene Imadenovec-drba (Papzimeos) - these will require new prior authorizations. Review and update existing prior authorization procedures for 38 revised medical drug policies including oncology, autoimmune, and specialty treatments. Contact BCBSND at 833-777-5779 for Medicaid Expansion authorization questions.