Medicare AdvantageCoverageMedium impact
MA08.112a, Givosiran (Givlaari) and Panhematin (Hemin)
Independence Blue Cross·Hematology, Endocrinology, Gastroenterology·Medical Policy
Effective date
May 19, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.112a has been updated with changes to medical necessity criteria, medical coding, and general guidelines for Givosiran (Givlaari) and Panhematin (Hemin) treatments. This affects billing and coverage requirements for these specialized medications used in treating certain genetic disorders.
Action Required
By May 19, 2025: Billing team must review updated medical necessity criteria for Givosiran (Givlaari) and Panhematin (Hemin) claims. Access the full policy at the source URL to understand new coding guidelines and documentation requirements. Update billing procedures and prior authorization protocols for Medicare Advantage patients receiving these medications.