Medical Policy Updates
Blue Cross and Blue Shield of Nebraska (BCBSNE) is proud to work with our provider network to serve your patients, our members. We are updating several medical policies. Please review the changes and effective dates outlined here:
Effective January 1, 2027
New Medical Policies
Medical Policy: X.242 OptimizeRX
Effective Date:01/01/2027
Preauthorization Required: Yes
Policy:
This is an advance notice of an update that will have implications to medical policy X.242 OptimizeRX. As a result, all preferred and non-preferred products will require the patient to have a documented contraindication, intolerance, or inadequate response to a preferred product before coverage of a nonpreferred product will be considered.
Therefore, step therapy requirements apply to both treatment-naïve and established patients receiving nonpreferred products.