Medicare AdvantageCoverageLow impact
MA08.034d, Enzyme Replacement Therapy for Mucopolysaccharidosis (e.g., Aldurazyme®, Elaprase®, Vimizim®, Naglazyme®, Mepsevii™, etc.)
Independence Blue Cross·Endocrinology, Pediatrics, General Practice·Pharmacy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
This is a Medicare Advantage policy reissue for enzyme replacement therapy coverage for Mucopolysaccharidosis, affecting drugs like Aldurazyme, Elaprase, Vimizim, Naglazyme, and Mepsevii. The policy will be reissued effective April 1, 2026, with updated guidance posted April 3, 2026.
Action Required
By April 1, 2026: Billing team should review the full updated policy document at the provided URL to understand any changes to coverage criteria, prior authorization requirements, or billing guidelines for enzyme replacement therapy drugs used to treat Mucopolysaccharidosis. Update billing procedures and prior authorization workflows as needed based on the complete policy details.