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Medicare AdvantageCoverageMedium impact

MA08.029d, Natalizumab (Tysabri®) and Related Biosimilars

Independence Blue Cross·Neurology, Internal Medicine, Family Medicine·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage policy MA08.029d for Natalizumab (Tysabri®) and related biosimilars has been updated, effective October 1, 2025. This affects billing and coverage requirements for this multiple sclerosis medication under Medicare Advantage plans.

Action Required

Action needed
By October 1, 2025: Review updated policy MA08.029d for Natalizumab (Tysabri®) billing requirements under Medicare Advantage plans. Billing team should verify current prior authorization requirements and coverage criteria for this medication and related biosimilars. Update billing procedures and staff training accordingly to ensure compliance with new policy guidelines.