Medicare AdvantageCoverageMedium impact
MA08.050c, Alpha-1 Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira)
Independence Blue Cross·Pulmonology, Internal Medicine·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated medical necessity criteria for Alpha-1 Antitrypsin therapy drugs including Prolastin-C, Aralast NP, Glassia, and Zemaira. The billing team must review new documentation requirements and prior authorization criteria for these specialty medications.
Action Required
By July 1, 2025: Billing team must access the full policy at medpolicy.ibx.com to review updated medical necessity criteria for Alpha-1 Antitrypsin therapy. Update prior authorization workflows and documentation requirements for Prolastin-C, Aralast NP, Glassia, and Zemaira. Notify providers of new criteria to ensure proper documentation before treatment initiation.