Medical Policy and Coding Updates - May 2026
Premera Washington policy changes carry effective dates from May 1, 2026 through September 4, 2026, and all of those dates had passed as of 2026-11-05. Several services now require review for medical necessity and prior authorization, including Prostate Artery Embolization, Hematopoietic Cell Transplantation for Acute Myeloid Leukemia, and Diagnosis and Treatment of Sacroiliac Joint Pain, and several drugs and procedures now also require review for site of service. Other changes add or remove drugs from pharmacy criteria, add quantity limits, extend initial authorization periods, and mark some procedures as investigational.