All PlansCoverageMedium impact
Medical Policy and Coding Updates - July 2020
Premera Blue Cross·WA · Oncology, Rheumatology, Gastroenterology +5 more·Medical Policy
Effective date
Jul 2, 2020
We identified it
Jun 18, 2026
Summary
Multiple policy updates effective between July 2, 2020 and October 2, 2020 covering new drug coverage criteria, site of service reviews for specialty medications, and updated imaging guidelines. Key changes include new oncology drugs, infertility treatments, and revised radiology appropriateness guidelines.
Action Required
Review all policy effective dates (July 2, August 7, August 16, September 4, and October 2, 2020) and update prior authorization requirements for newly covered specialty drugs including oncology medications (Kyprolis, Velcade, Jevtana, Xofigo), infertility drugs (Bravelle, Follistim AQ, Pregnyl), and site of service reviews for infliximab and rituximab biosimilars. Update radiology pre-authorization criteria per AIM Specialty Health guidelines for chest imaging, oncology imaging, and sleep studies.