Federal Employee Program (FEP) Medical Prior Authorization Drug List
Lists drugs within the Federal Employee Program (FEP) that require prior authorization and identifies therapeutic classes; intended for providers and prior authorization reviewers submitting and reviewing requests through Novologix for Blue Cross and Blue Shield Federal Employee Program.
No material clinical or coverage changes in this revision.
Coverage Criteria
This list document does not contain detailed medical necessity criteria or exclusions. Detailed coverage criteria and exclusions are contained in the FEP Medical Policy Manual available on fepblue.org; this list only identifies drugs within the Federal Employee Program that require prior authorization.
Provider Actions and Prior Authorization Requirements
Prior authorization required for listed drugs
Drugs listed in this FEP Medical Prior Authorization Drug List require prior authorization under the Blue Cross and Blue Shield Federal Employee Program and must be submitted and reviewed through Novologix.
Submit and review requests via Novologix
Providers must submit and review prior authorization requests through Novologix per the FEP process and refer to the FEP Medical Policy Manual on fepblue.org for specific criteria.
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