May 3, 2018

Effective July 1, 2018, BlueCross BlueShield of South Carolina and BlueChoice^® HealthPlan will conduct all utilization reviews for prescribed drugs Korlym and Xyrem. Reviews for these drugs were previously conducted by CVS Caremark, our Pharmacy Benefit Manager (PBM) partner. This change applies to members of all BlueCross and BlueChoice commercial and Affordable Care Act plans.

To initiate the review process for Korlym and Xyrem, please call the precertification number on the back of the member’s identification card. All requests should be submitted with the required supporting documentation below:

NOTE: Additional supporting clinical documentation may be required to render a decision.

If you have questions about this bulletin, you may contact Provider Education at 803-264-4730 or submit your questions using the Provider Education Contact Form. 

BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.