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September 2017 Medical Policies
EmblemHealth·Endocrinology, Rheumatology, Hematology +4 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth has issued new and revised medical policies for September 2017 covering multiple specialty medications and procedures. The update includes new policies for enzyme replacement therapies, immunosuppressants, and specialized procedures like intrastromal corneal ring segments, plus revised coverage criteria for hemophilia treatments and erythropoiesis stimulating agents.
Action Required
Immediately: Review all new and revised EmblemHealth policies at the provided URL to understand specific coverage criteria changes. Billing team must update prior authorization requirements and coverage determinations for affected medications including Vpriv, Fabrazyme, Elaprase, Elelyso, Lumizyme, Orencia, Simponi Aria, and Ocrevus. Update encounter forms and billing system rules for hemophilia infusion therapy and erythropoiesis stimulating agents per revised guidelines.