CommercialPrior AuthLow impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Gastroenterology, Hematology, Internal Medicine·Medical Policy
Effective date
Aug 15, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated authorization renewal criteria for Givosiran (GIVLAARI), a medication for acute hepatic porphyria. The new criteria require documented clinical improvement, absence of severe liver enzyme elevations, and manageable side effects for continued coverage.
Action Required
Before August 15, 2026: Providers treating patients on Givosiran (GIVLAARI) must document in medical records: 1) Clinical improvement (reduced porphyria attacks or hemin requirements), 2) Absence of severe transaminase elevations, and 3) Tolerable side effects. Update prior authorization renewal templates to include these specific criteria. Without proper documentation, renewal authorizations will be denied.