Who is affected by this change?

This affects Independence Blue Cross Oncology, Hematology providers on Medicare Advantage plans.

When does this change take effect?

This change is effective Apr 20, 2026.

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Medicare AdvantageCoverageMedium impact

MA08.165c, Epcoritamab-bysp (EPKINLY®)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Apr 20, 2026

We identified it

Jun 19, 2026

Days to comply

—

Summary

Medicare Advantage has updated the medical necessity criteria and general guidelines for Epcoritamab-bysp (EPKINLY®), a pharmacy-related treatment. This appears to be an informational update to existing policy requirements rather than a complete coverage change.

Action Required

Action needed

By April 20, 2026: Review updated medical necessity criteria for Epcoritamab-bysp (EPKINLY®) prescriptions. Ensure providers understand any revised documentation requirements when prescribing this medication for Medicare Advantage patients. Contact the payer or access the full policy details to understand specific changes to approval processes.

Related policy hubs

Independence Blue Cross policies Oncology Hematology