Medicare AdvantageCoverageMedium impact
MA08.183a, Zenocutuzumab-zbco (Bizengri®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jun 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage plans have updated medical necessity criteria for Zenocutuzumab-zbco (Bizengri®), a specialty pharmacy drug. This change establishes new coverage requirements that will affect billing and prior authorization processes for this medication.
Action Required
Before June 1, 2026: Billing team and providers must review updated medical necessity criteria for Zenocutuzumab-zbco (Bizengri®) prescriptions. Update prior authorization workflows and documentation requirements in billing system. Ensure providers understand new criteria to avoid claim denials for this specialty medication.