MHCP Pharmacy Program Policy Activity Effective April 1, 2025

QP30-25 Accurate Place of Service on Claim Submission

2q-2025-utilization-management-updates.pdf

2023 Prior Authorization approvals and appeals statistics — Blue Cross Plans

Prior Authorizations for Services Provided from January 1, 2023 to December 31, 2023 — Blue Cross Plans

2023 Prior Authorization approvals and appeals statistics — Blue Plus Plans

Prior Authorizations for Services Provided from January 1, 2023 to December 31, 2023 — Blue Plus Plans

Insulin Combination Agents (Soliqua, Xultophy) - Commercial

Quantity Limit

Sohonos - Commercial

Prior Authorization, Quantity Limit

Hympavzi - Commercial

Prior Authorization, Quantity Limit

Hympavzi - Medicaid

Prior Authorization, Quantity Limit

Interleukin-31 (IL-31) Inhibitor - Commercial

Prior Authorization, Quantity Limit