Oakland Southfield Physicians

OSP News

Blue Care Network and Blue Cross Blue Shield Pharmacy Updates

Posted: 03/03/2020

Save time and submit prior authorization requests electronically for pharmacy benefit drugs.

Providers can now use their electronic health record or CoverMyMeds® to submit prior authorizations for Blue Cross Blue Shield of Michigan and Blue Care Network commercial members. Electronic prior authorization (ePA) replaces faxing and phone calls so you can focus less on administrative tasks and more on patient care.

Benefits of electronic prior authorization:

  • Auto approvals for select drugs
  • Improved turnaround time for review and decisions
  • Easier to use for prescribers, nurses and office staff
  • Works for commercial pharmacy benefits that require prior authorization or step therapy
  • Keeps all your ePA documentation and requests in one place

Click here for more information about how to complete an ePA.

Soma no longer covered starting May 1, 2020.

The following alternatives that have similar effectiveness, quality, and safety will be covered:

  • Flexeril® (cyclobenzaprine)
  • Norflex® (orphenadrine)
  • Robaxin® (methocarbamol)

Adherence Program – Copay Savings

Enrolled members who are adherent to their drug therapies can be rewarded with discounts on their prescriptions for select medications. Each time they refill a prescription, they may receive a bigger discount.

Members will receive communications from Sempre Health based on their adherence to the drugs listed below:

  • Ozempic
  • Eliquis
  • Spiriva Respimat
  • Trulicity
  • Pradaxa

 

  • Victoza
  • Xarelto
 

Members can enroll by text, phone, or website. The member receives a discount ID by text to share at the pharmacy to pay a discounted rate for a prescription refill. Members will receive text reminders to refill prescriptions and discounts if they fill them regularly as prescribed.

BCBSM introduces $0 drug tier for individual Medicare Part D plans

Not all Medicare members have plans with a $0 Tier. Members can call BCBSM customer service to see if their plan is included. Members must use a preferred pharmacy to qualify for the $0 Tier.

Drugs on the $0 Tier:

  • ACE Inhibitors (lisinopril, captopril, etc.)
  • Angiotensin Receptor Blockers (losartan, valsartan, etc.)
  • Statins
  • Sulfonylureas (glimepiride, glipizide, glyburide)
  • Metformin

 

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