CommercialCoverageMedium impact
Drug Policy Criteria Change
Arkansas Blue Cross Blue Shield·Oncology, Hematology, Pediatrics +3 more·Pharmacy
Effective date
Jun 14, 2026
We identified it
Jun 19, 2026
Summary
This policy update adds or expands coverage criteria for 30+ specialty drugs, primarily oncology and rare disease medications, across multiple formulary tiers. Changes include new indications for cancer treatments, updated testing requirements for biologics, and revised documentation requirements for growth hormones and precocious puberty treatments.
Action Required
By June 14, 2026: Review current patient populations on affected medications (Poteligeo, Zolinza, Imfinzi, Jakafi, growth hormones, GnRH agonists, etc.). Update prior authorization requests to reflect new coverage criteria and documentation requirements. For oncology patients, ensure NCCN guideline compliance is documented. For pediatric endocrinology, update growth chart documentation to include medical record notes showing heights and growth velocities. For TB screening requirements on biologics, ensure evaluation documentation is complete before treatment initiation.