CommercialPrior AuthLow impact
Luspatercept-aamt (Reblozyl®)
BCBS Tennessee·TN · Hematology, Oncology·Medical Policy
Effective date
Jun 30, 2026
We identified it
Jun 17, 2026
Summary
BlueCross BlueShield of Tennessee is implementing a new medical policy for Luspatercept-aamt (Reblozyl®) covering treatment of anemia in beta thalassemia, myelodysplastic syndromes, and myelofibrosis. The drug requires prior authorization with specific documentation requirements and must be prescribed by specialists.
Action Required
Before June 30, 2026: Billing team must implement prior authorization requirements for Luspatercept-aamt (Reblozyl®) claims. Update system to flag cases requiring hematologist/oncologist prescription and documentation of hemoglobin levels, transfusion history, and diagnostic confirmation. Create workflow to ensure 16-24 week authorization periods are tracked for renewals.