Pharmacy Policies Available Online

Blue Cross Blue Shield of North Dakota (BCBSND) regularly 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 medical drug policies are new:

The following medical drug policies are new and specific for Medicaid Expansion:
Note: There may be corresponding policies for our Commercial lines of business or policies that apply to both Commercial and Medicaid Expansion lines of business.

The following medical drug policies were revised:

The following medical drug policies had a coding change effective 1/1/2023:

The following medical drug policies were reviewed with no clinical content change:

The following new retail pharmacy Utilization Management programs are effective 4/1/2023:

  • Hyftor (sirolimus) Prior Authorization with Quantity Limit – NetResults only
  • Relyvrio (sodium phenylbutyrate/taurursodiol) Prior Authorization with Quantity Limit

The following medical drug policies are revised and specific for Medicaid Expansion:
Note: There may be corresponding policies for our commercial lines of business or policies that apply to both commercial and Medicaid Expansion lines of business.