All PlansPrior AuthMedium impact
Daratumumab and hyaluronidase-fihj (Darzalex Faspro®)
BCBS Tennessee·TN · Oncology, Hematology·Medical Policy
Effective date
Jul 31, 2026
We identified it
Jun 17, 2026
Summary
New medical policy for Darzalex Faspro (daratumumab and hyaluronidase-fihj) establishing prior authorization requirements for multiple myeloma, light chain amyloidosis, POEMS syndrome, and related conditions. Policy covers FDA-approved indications and compendial uses with specific combination therapy requirements and documentation needs.
Action Required
By July 31, 2026: Oncology billing team must implement prior authorization requirements for Darzalex Faspro. Update billing system to require prior auth documentation including t(11:14) translocation testing where applicable. Train staff on coverage criteria for multiple myeloma, light chain amyloidosis, and POEMS syndrome indications. Update encounter forms to capture required combination therapy details and treatment history. Claims without proper authorization will be denied.