As part of our ongoing efforts to make high-quality and affordable healthcare available to our members, BCBSRI regularly reviews the list of prescription drugs we cover under our medical benefit. Our goal is to make sure that our members continue to have access to effective medications at the lowest possible cost. As a result, the following changes are being made to the Medical Drug Review (MDR) program. Existing and new prior authorization reviews will continue to be handled by our pharmacy benefits manager, Prime Therapeutics.

Additionally, for our Commercial line of business, prior authorization criteria updates are being made to the following medical drugs effective July and August. The following medical drugs will require documented trial and failure of alternative medical drugs as noted below.