CommercialCoverageLow impact
State and School Employees' Health Insurance Plan - Veopoz (pozelimab)
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology, Pediatrics, Internal Medicine·Medical Policy
Effective date
Mar 20, 2025
We identified it
Jun 20, 2026
Summary
New policy establishes that Veopoz (pozelimab-bbfg) injections for CD55-deficient protein-losing enteropathy (CHAPLE disease) are considered not medically necessary by Mississippi State and School Employees' Health Insurance Plan. Claims for this medication and related administration services will be denied.
Action Required
Immediately: Billing team must flag HCPCS code J9376 (pozelimab-bbfg injection) as non-covered for Mississippi State and School Employees' Health Insurance Plan members. Update billing system to alert staff that this medication and related administration services are considered not medically necessary and will be denied. Inform providers that alternative treatments should be considered for CHAPLE disease patients with this insurance.