Currentblue cross blue shield - alabamaPolicy N/A

PRIME THERAPEUTICS PROVIDER-ADMINISTERED SPECIALTY PHARMACY DRUG LIST

List of provider-administered specialty medications for Blue Cross Blue Shield - Alabama members managed by Prime Therapeutics. Specifies which drugs are designated specialty, which require prior authorization, which are limited distribution, and billing pathway exceptions (buy-and-bill vs specialty pharmacy) including PEEHIP-specific rules and in-network specialty pharmacy requirements.

Policy Summary

Payerblue cross blue shield - alabama

PolicyPRIME THERAPEUTICS PROVIDER-ADMINISTERED SPECIALTY PHARMACY DRUG LIST

Policy CodePolicy N/A

Change TypeNo material change

Effective Date

Next Review Date

Key ActionObtain prior authorization for any medication in this list annotated with (PA) before dispensing or administration.

POLICY UPDATE CHANGES

No material clinical or coverage changes.

multipleTherapeutic categories listed

PA indicatedPrior authorization annotations present

limitedLimited distribution drugs present

PEEHIPPEEHIP-specific exceptions

Coverage Summary & Scope

List of provider-administered specialty medications for Blue Cross Blue Shield - Alabama members managed by Prime Therapeutics. Specifies which drugs are designated specialty, which require prior authorization (annotated with (PA)), which are limited distribution (marked with *), and billing pathway exceptions (buy-and-bill vs specialty pharmacy) including PEEHIP-specific rules and in-network specialty pharmacy requirements.