CommercialCoverageMedium impact
Fast Facts Newsletter - April (Special Edition) 2025
HealthPartners·Ophthalmology, Cardiology, Orthopedics +2 more·Pharmacy
Effective date
Jun 1, 2025
We identified it
Jun 19, 2026
Summary
HealthPartners is withdrawing Ranibizumab (Cimerli) from market on March 31, 2025, but patients can switch to Lucentis or Byooviz without new prior authorization. Additionally, 18 Cohere Health medical policies for various procedures will be revised effective June 1, 2025.
Action Required
By March 31, 2025: For patients currently on Cimerli (Ranibizumab), coordinate with providers to switch to Lucentis or Byooviz without requiring new prior authorization. By May 31, 2025: Review updated Cohere Health coverage criteria policies at the HealthPartners Zendesk link for all 18 affected procedures including cardiac devices, spinal procedures, and joint surgeries. Update prior authorization workflows and billing system rules based on revised criteria to avoid claim denials starting June 1, 2025.