Medicare AdvantageCoverageMedium impact
MA08.052p, Denosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®)
Independence Blue Cross·Rheumatology, Endocrinology, Oncology +3 more·Pharmacy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.052p has been updated for Denosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®). This is a fresh policy update that will take effect April 1, 2026, likely affecting coverage criteria or prior authorization requirements for these osteoporosis medications.
Action Required
By April 1, 2026: Review the complete policy details at the source URL to determine specific changes to coverage criteria, prior authorization requirements, or billing procedures for Denosumab and Romosozumab medications. Update billing workflows and provider documentation requirements accordingly once full policy details are available.