Draft Provider-Administered Drug Policies 

Provider-Administered drugs require that a member’s medical condition meets the policy requirements prior to being given (precertification) unless otherwise specified. Providers must submit a request for pre-service review in order to be approved. If the provider does not receive approval for precertification, the plan will pay no benefits.

Click the link below to locate specific drug policy information.
Draft Provider-Administered Drug Policies

Precertification for the provider-administered drugs linked above is required when administered in a provider’s office, outpatient facility, or home infusion setting. Exceptions to this include: Gene and Cell therapies, and particular oncology treatments requiring an initial inpatient stay.

Members can request a copy of a full drug policy, by calling the Customer Service number on their ID card.

Comment on Draft Drug Policies

Participating providers are invited to submit for consideration scientific, evidence-based information, professional consensus opinions, and other information supported by medical literature relevant to our draft policies.

We accept comments for 45 days from the posting date listed on the draft policy.

Make sure your voice is heard by providing feedback directly to us:

• Complete our policy feedback form online, or
   
• Send comments and supporting documentation to us by mail or fax:

Blue Cross and Blue Shield of Alabama
Attn: Pharmacy Department
P.O. Box 995
Birmingham, AL 35298-0001

Fax: 205-220-9576