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Cigna Specialty Care Options programs drug list changes
Effective date
Sep 1, 2026
Identified
Oct 17, 2026
Summary
Cigna has expanded its Specialty Care Options (SCO) and SCO+ programs to include two additional drugs—Armlupeg® (pegfilgrastim-unne) and PasatruTM (garetosmab-grts)—on both drug lists effective September 1, 2026. These programs conduct medical necessity site-of-care reviews to redirect patients to lower-intensity care settings when clinically appropriate. Billing teams should verify whether these drugs are used in practice and ensure prior authorization workflows account for the expanded drug list.
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What to do
Action · 4 steps
01Already effective September 1, 2026: Verify whether the practice administers Armlupeg® (pegfilgrastim-unne) or PasatruTM (garetosmab-grts) to Cigna patients.
02For affected specialty medications, billing and clinical staff should confirm that prior authorization requests for these drugs are submitted to Cigna's SCO/SCO+ programs and that site-of-care review requirements are integrated into the prior authorization workflow.
03Obtain the complete SCO and SCO+ drug list from Cigna's provider reference materials to identify all covered specialty medications subject to site-of-care medical necessity review.
04Document current practice applicability, as the policy became effective in the past and may already be in operation.
Original notice
Cigna Specialty Care Options programs drug list changes
providernewsroom.com · Always check the source before changing claims.