Medicare AdvantageCoverageMedium impact
MA08.173a, Tislelizumab-jsgr (Tevimbra®)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jun 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated medical necessity criteria for Tislelizumab-jsgr (Tevimbra®), an oncology pharmacy drug. This change affects coverage requirements and likely documentation needed for this specialty cancer medication.
Action Required
Before June 1, 2026: Oncology billing team must review updated medical necessity criteria for Tislelizumab-jsgr (Tevimbra®) at the provided URL. Update prior authorization workflows and documentation requirements in billing system. Ensure providers understand new criteria to prevent claim denials for this cancer medication.