Medicare AdvantagePrior AuthMedium impact
Updated Category for Medicare Advantage Part B Step Therapy
Florida Blue·FL · Oncology, Hematology·Medicare
Effective date
Oct 1, 2025
We identified it
Jun 16, 2026
Summary
Florida Blue Medicare updated its Part B Step Therapy program for colony-stimulating factors, adding several new non-preferred products that now require step therapy. Providers must try preferred alternatives (Fulphila, Udenyca, Nyvepria) before using the newly added non-preferred drugs.
Action Required
By October 1, 2025: Providers must prescribe preferred colony-stimulating factors (Fulphila, Udenyca, Nyvepria) before non-preferred products. Billing team should update prior authorization workflows for the newly added non-preferred drugs (Fylnetra, Rolvedon, Stimufend, Ryzneuta, Nypozi, Ziextenzo). Update encounter forms and EMR templates to remind providers of step therapy requirements.