Medicare AdvantageCoverageMedium impact
MA08.163d, Glofitamab-gxbm (Columvi)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jul 28, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated medical necessity criteria for Glofitamab-gxbm (Columvi), a specialized oncology medication. This affects coverage requirements and potentially prior authorization processes for this drug effective July 28, 2025.
Action Required
Before July 28, 2025: Billing team must review updated medical necessity criteria for Glofitamab-gxbm (Columvi) prescriptions. Update prior authorization processes and ensure documentation meets new Medicare Advantage requirements. Coordinate with providers to verify medical necessity documentation is complete before submitting claims.