Medicare AdvantageCoverageLow impact
MA08.044k, Eculizumab (Soliris®) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris™) for intravenous administration
Independence Blue Cross·Hematology, Nephrology·Pharmacy
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.044k for Eculizumab (Soliris®) and related biosimilars, Ravulizumab-cwvz (Ultomiris™) for intravenous administration has been updated. This affects coverage and billing for these specialty medications used to treat rare blood disorders like paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome.
Action Required
Review updated Medicare Advantage policy MA08.044k for any changes to coverage criteria, prior authorization requirements, or billing guidelines for Eculizumab (Soliris®) and Ravulizumab-cwvz (Ultomiris™). Update billing procedures accordingly if your practice administers these specialty medications for rare blood disorders.