High call volumes

Our member and provider services may be experiencing higher than normal call volumes today. We encourage you to utilize alternative forms of communication including contacting a Care Guide through bcbsnd.me and Availity Essentials Provider Portal.

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May 2025 Pharmacy Policies Updates

Impacting our Commercial line of business only

Blue Cross Blue Shield of North Dakota (BCBSND) continually develops and revises pharmacy policies in response to rapidly changing pharmaceutical requirements. Our commitment is to update the provider community as pharmacy policies are adopted and/or revised.

The following Commercial medical drug policies are new and effective May 1, 2025:

*see www.gatewaypa.com/policydisplay/52 on or after May 1, 2025.

  • Avtozma IV (tocilizumab-anoh)
  • Encelto
  • Omlyclo (omalizumab-igec)
  • Omalizumab-igec
  • Osenvelt (denosumab-bmwo)
  • Stoboclo (denosumab-bmwo)

The following Commercial prior authorization medical drug policies have revisions effective May 30, 2025:

*see www.gatewaypa.com/policydisplay/52

  • Adzynma
  • Akynzeo IV
  • Aldurazyme
  • Bavencio
  • Benlysta
  • Cerezyme
  • Eculizumab
  • Elaprase
  • Elelyso
  • Elfabrio
  • Fabrazyme
  • Imfinzi
  • Imjudo
  • Jemperli
  • Kanuma
  • Keytruda
  • Lamzede
  • Lenmeldy
  • Libtayo
  • Loqtorzi
  • Lumizyme
  • Mepsevii
  • Naglazyme
  • Nexviazyme
  • Niktimvo
  • Opdivo
  • Pombiliti
  • Poteligeo
  • Revcovi
  • Romidepsin
  • Saphnelo
  • Tecentriq IV
  • Tevimbra
  • Tremfya
  • Unloxcyt
  • Ustekinumab
  • Vimizim
  • VPRIV
  • Xenpozyme
  • Yervoy
  • Ziihera
  • Zynyz

The following Commercial post service claim edit medical drug policies have revisions effective May 1, 2025:

*see www.gatewaypa.com/policydisplay/52

  • Alpha-1 Proteinase Inhibitors
  • Beleodaq
  • Brineura
  • Cinvanti
  • Fosaprepitant IV
  • Iluvien
  • Mylotarg