Medical Pharmacy Implementation Prior Authorization Program (BCBSKS)
Notifies providers that Blue Cross and Blue Shield of Kansas is transitioning management of certain medical-benefit specialty drugs to Prime Therapeutics' Medical Pharmacy Solutions (MPS) team, effective August 15, 2025, and describes prior authorization (PA) submission workflows, impacted places of service, in-scope HCPCS/J-codes and provider responsibilities.
Responsibility for prior authorization reviews for the listed medical-benefit specialty drugs is transitioned to Prime Therapeutics Medical Pharmacy Solutions, effective 2025-08-15.
PA submission workflow changed for providers previously using Prime MDR or Prime Therapeutics Pharmacy Benefit Team via CoverMyMeds/fax.
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