Medicare AdvantageCoverageMedium impact
MA08.040, Telisotuzumab vedotin-tllv (Emrelis™)
Independence Blue Cross·Oncology, Pharmacy·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
MA08.040 is a new pharmacy policy effective 10/01/2025 establishing coverage and billing requirements for Telisotuzumab vedotin-tllv (Emrelis™), a novel therapeutic agent. This policy applies to Medicare Advantage plans and requires billing and clinical teams to implement new prior authorization, documentation, and coding procedures for this drug.
Action Required
By 10/01/2025: Billing team must obtain and review the full policy text from https://medpolicy.ibx.com/ibc/ma/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=10&FilterField2=MPSiteActivityLogYear&FilterValue2=2025 to identify specific HCPCS drug codes, prior authorization requirements, and documentation standards for Emrelis™ (telisotuzumab vedotin-tllv). Update billing system, pharmacy benefit management workflows, and prior authorization protocols accordingly. Ensure all prescribers and pharmacy staff are trained on new requirements. Pharmacy team must implement prior auth procedures before dispensing to prevent claim denials. Without full policy details in this summary, retrieve complete policy documentation immediately to avoid compliance gaps.