Pharmacy Prior Authorization Update: Glucagon-like peptide-1 (GLP-1) Agonists Update

Blue Cross Blue Shield of North Dakota (BCBSND) recently updated the GLP-1 prior authorization program summary criteria to include the requirement of lab test results that confirms the patient’s type 2 diabetes diagnosis (e.g., A1C greater than or equal to 6.5%).

Please note, the lab value required is what prompted the type 2 diabetes diagnosis, not the most recent values. Providers must submit the required lab test results for patients to be considered for approval of coverage of diabetic GLP-1 agonists.

This impacts our Commercial line of business only.

Questions?
Contact our Provider Service Center at 1-800-368-2312.