Medicare AdvantageCoverageLow impact
MA08.131b, Lumasiran (Oxlumo®)
Independence Blue Cross·Nephrology, Pediatrics, Endocrinology·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.131b for Lumasiran (Oxlumo®) has been updated with changes effective October 1, 2025. This affects coverage and billing requirements for this rare disease medication used to treat primary hyperoxaluria type 1.
Action Required
By October 1, 2025: Review updated Medicare Advantage policy MA08.131b for Lumasiran (Oxlumo®) coverage requirements. Billing team should verify current prior authorization requirements and coverage criteria for this specialty medication before submitting claims for Medicare Advantage members.