CommercialPrior AuthMedium impact
08.01.79f, Dostarlimab-gxly (Jemperli)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
May 19, 2025
We identified it
Jun 19, 2026
Summary
Medical necessity criteria for Dostarlimab-gxly (Jemperli), a cancer immunotherapy drug, have been updated for commercial insurance plans. This affects coverage determination and prior authorization requirements for this specialty oncology medication.
Action Required
Before May 19, 2025: Oncology billing team must review updated medical necessity criteria for Dostarlimab-gxly (Jemperli) prescriptions. Update prior authorization workflows and ensure documentation meets new criteria requirements. Verify coverage determination processes align with updated policy to prevent claim denials.