Medicare AdvantageCoverageMedium impact
MA08.110d, Luspatercept–aamt (Reblozyl®)
Independence Blue Cross·Hematology, Oncology·Pharmacy
Effective date
Jan 17, 2025
We identified it
Jun 19, 2026
Summary
Updated Medicare Advantage policy for Luspatercept-aamt (Reblozyl®) with changes to coverage criteria, medical necessity requirements, and billing codes. This affects pharmacy benefits for this specialty medication used primarily in hematology treatments.
Action Required
By January 17, 2025: Billing team must review updated MA08.110d policy for Luspatercept-aamt (Reblozyl®) at the provided IBX Medicare Advantage portal. Update prior authorization requirements and medical necessity documentation criteria for this medication in billing system. Verify current coding guidelines and coverage position changes to ensure compliant claims submission.