CommercialCoverageMedium impact
Updates on Lupron Depot Injections for State Health Plan Members
BlueCross BlueShield of South Carolina·SC · Oncology, Endocrinology, OB-GYN +1 more·Benefits
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Effective January 1, 2026, Lupron Depot injections for State Health Plan members transitioned from pharmacy benefit coverage to medical benefit coverage. Prior authorization is still required and must be submitted through MBMNow via My Insurance Manager.
Action Required
Immediately: Billing team must update procedures to bill Lupron Depot injections through medical benefit instead of pharmacy benefit for State Health Plan members. Continue obtaining prior authorization through MBMNow accessible via My Insurance Manager before administering. Update billing system settings and staff training to prevent claim denials.