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 1, 2026.

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Medicare AdvantageCoverageMedium impact

MA08.189a, Pembrolizumab and berahyaluronidase alfa-pmph (KEYTRUDA QLEX™)

Independence Blue Cross·Oncology, Hematology·Pharmacy

Effective date

Apr 1, 2026

We identified it

Jun 19, 2026

Days to comply

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Summary

Medicare Advantage has updated their policy for Pembrolizumab and berahyaluronidase alfa-pmph (KEYTRUDA QLEX™), a cancer immunotherapy drug. This policy change will take effect April 1, 2026 and may affect coverage criteria, prior authorization requirements, or billing procedures for this oncology medication.

Action Required

Action needed

Before April 1, 2026: Oncology billing team must review the full policy details at the provided URL to understand specific changes to KEYTRUDA QLEX coverage, prior authorization requirements, or billing procedures. Update billing software and prior authorization workflows as needed based on the complete policy content.

Related policy hubs

Independence Blue Cross policies Oncology Hematology