Medicare AdvantagePrior AuthMedium impact
MA08.126c, Inebilizumab-cdon (Uplizna®)
Independence Blue Cross·Neurology·Pharmacy
Effective date
Mar 23, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.126c for Inebilizumab-cdon (Uplizna®) has been updated with changes to medical necessity criteria and medical coding requirements. This affects billing and coverage determination for this specialty pharmaceutical used primarily in neurology.
Action Required
By March 23, 2026: Review updated medical necessity criteria for Inebilizumab-cdon (Uplizna®) in Medicare Advantage plans. Update prior authorization processes and ensure proper medical coding compliance for this pharmaceutical. Billing team should verify current coding requirements and documentation standards at the source URL before the effective date.