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OfficeLink Updates - May 2026 notices and reminders (PDF)
Aetna·Oncology, Hematology, Rheumatology +3 more·Newsletter
Effective date
May 1, 2026
We identified it
Jun 19, 2026
Summary
Aetna has updated their National Precertification List with multiple changes taking effect between May 2026 and January 2027. Several drugs will now require precertification including ustekinumab-srlf, ranibizumab-nuna, and others, while Fulphila will no longer require precertification for Medicare patients.
Action Required
By May 1, 2026: Billing team must update precertification requirements in billing system for specified drug codes. Stop requiring precertification for Fulphila (Q5108) for Medicare patients. Add precertification requirements for ustekinumab-srlf (Q5098), ranibizumab-nuna (Q5124), and other listed drugs with their respective J-codes. Update staff workflow to submit precertification requests at least two weeks in advance through Availity portal. Claims will be denied without proper precertification.