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Medicare AdvantageCoverageMedium impact

20-580 Stay Up to Date with Medication Trend Updates and Formulary Changes - 3rd Quarter 2020

Health Net·CA · Family Medicine, Internal Medicine, Endocrinology +2 more·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Health Net has withdrawn weight-loss drugs Belviq and Belviq XR from coverage due to FDA cancer risk findings, implemented zero copayment programs for Medicare Advantage members on select chronic disease medications, and updated formulary tiers for multiple medications in Q3 2020.

Action Required

Action needed
Immediately: Stop prescribing and dispensing Belviq and Belviq XR (lorcaserin). Providers must inform current patients taking lorcaserin about cancer risks and discontinue the medication. Billing team should verify Medicare Advantage members' zero copayment eligibility for listed statins, anti-diabetic agents, and ACE inhibitors/ARBs before processing claims. Review updated formulary changes for proper tier billing.

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