CommercialCoverageLow impact
State and School Employees' Health Insurance Plan - Gene Therapy for the Treatment of Metachromatic Leukodystrophy
Blue Cross & Blue Shield of Mississippi·MS · Pediatrics, Neurology, Oncology +1 more·Medical Policy
Effective date
Jan 20, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi has added a new policy explicitly stating that Lenmeldy (atidarsagene autotemcel), a gene therapy for metachromatic leukodystrophy, is not medically necessary due to unknown long-term durability. All related administration and delivery services are also considered not medically necessary.
Action Required
Immediately: Billing team must flag HCPCS codes J3391 and J3590 as non-covered for BCBS Mississippi State and School Employees' Health Insurance Plan members. Update billing system to prevent submission of claims for Lenmeldy (atidarsagene autotemcel) and related administration services. All claims for these codes will be denied as not medically necessary.