Medicare AdvantageCoverageLow impact
MA08.094c, Voretigene Neparvovec-rzyl (Luxturna®)
Independence Blue Cross·Ophthalmology·Pharmacy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.094c for Voretigene Neparvovec-rzyl (Luxturna®) has been reissued and will take effect April 1, 2026. This is a pharmacy policy update affecting coverage criteria for this gene therapy medication used to treat inherited retinal dystrophy.
Action Required
By March 31, 2026: Billing team should review updated coverage criteria for Luxturna® (Voretigene Neparvovec-rzyl) in Medicare Advantage plans. Coordinate with ophthalmology providers to ensure proper documentation and prior authorization requirements are met for this specialized gene therapy before the effective date.