CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Korsuva (difelikefalin)
Blue Cross & Blue Shield of Mississippi·MS · Nephrology·Medical Policy
Effective date
Feb 24, 2026
We identified it
Jun 20, 2026
Summary
Mississippi State and School Employees' Health Insurance Plan now considers Korsuva (difelikefalin) injections for chronic kidney disease-associated pruritus not medically necessary, meaning claims will be denied. This affects patients on hemodialysis seeking treatment for severe itching.
Action Required
By February 24, 2026: Billing team must update system to flag HCPCS code J0879 (difelikefalin injection) as non-covered for Mississippi State and School Employees' Health Plan members. Notify providers that Korsuva injections will be denied and alternative covered treatments should be used for CKD-associated pruritus. Update prior authorization workflows to automatically deny requests for this medication.