Redirection of care Infusion Drugs

Blue Cross Blue Shield of Wyoming is introducing a new redirection of care program for certain medications. The prescription drugs listed below will be authorized when clinically appropriate in the most cost-effective setting.

If administration of the list of drugs below are not approved to be performed in an inpatient or outpatient hospital setting you can either redirect the infusion to a lower level cost of care such as free-standing infusion center, doctor’s office, pharmacy, or via home health. Failure to receive the service in an approved location could result in denial of claims.

Please be advised that while the service has been approved as medically appropriate, the member’s benefits require this service be provided in specific locations. 

If needed, our Redirection of Care Team can assist members with finding an appropriate site for care. Our team is available Monday-Friday, 8:00 am-5:00 pm, by calling (307) 823-6095 to assist you.

Please note, redirection of care does not affect your patient’s prescription drug benefits.

If a member is affected by this program, it will be noted in the authorization letter. 

Who is Impacted:
As of January 1, 2022, the list below are the medications that will be subject to the redirection of care program for administration in the most cost-effective setting:

RemicadeRituxab
AvastinKeytruda
HerceptinOpdivo
OcrevusSoliris
Somatuline 

This program will go into effect with new prescriptions or upon authorization renewal. Typically, medical authorizations expire one year from the date of the authorization.

Questions:
We have a Redirection of Care Team. If you’re currently taking one of these medications and have questions or concerns, please call 307-823-6095.

Availity Provider Portal
Submit Prior Authorization requests online.
Form
Submit request.
Provider Resources

Ready to join our network?

Back to Top