Medicare AdvantageCoverageMedium impact
MA08.110e, Luspatercept–aamt (Reblozyl®)
Independence Blue Cross·Hematology, Oncology·Pharmacy
Effective date
Mar 23, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.110e for Luspatercept-aamt (Reblozyl®) has been updated with changes to medical necessity criteria and medical coding requirements. This pharmacy policy affects coverage and billing requirements for this medication used primarily in hematologic conditions.
Action Required
By March 23, 2026: Review updated medical necessity criteria for Luspatercept-aamt (Reblozyl®) prescriptions. Update prior authorization processes and documentation requirements in billing system to align with new Medicare Advantage policy requirements. Ensure providers understand revised coding guidelines to prevent claim denials.