CommercialCoverageLow impact
State and School Employees' Health Insurance Plan - Reblozyl (luspatercept-aamt)
Blue Cross & Blue Shield of Mississippi·MS · Hematology, Oncology·Medical Policy
We identified it
Jun 20, 2026
Summary
State and School Employees' Health Insurance Plan updated coverage criteria for Reblozyl (luspatercept-aamt), a specialty drug for treating anemia in adult patients with beta thalassemia and myelodysplastic syndromes. The policy establishes detailed medical necessity requirements including specific hemoglobin levels, transfusion history, and contraindications, with initial 6-month approvals and 12-month renewals.
Action Required
Review current patients receiving Reblozyl to ensure documentation meets the updated medical necessity criteria including age ≥18 years, specific hemoglobin levels, transfusion requirements, and absence of contraindications. Ensure prescribers are hematologists or oncologists and dosing is within FDA-approved limits. Update prior authorization requests to include all required clinical documentation.