CommercialCoverageMedium impact
Drug Policy Criteria Change
Arkansas Blue Cross Blue Shield·Oncology, Endocrinology, Psychiatry +1 more·Pharmacy
Effective date
May 24, 2026
We identified it
Jun 19, 2026
Summary
This policy updates drug coverage criteria for five medications (Sogroya, Keytruda, Tafinlar, Mekinist, and Spravato) with expanded indications, modified treatment requirements, and updated documentation standards. The changes primarily affect oncology and endocrinology practices with multiple effective dates in 2026.
Action Required
By May 24, 2026: Review and update prior authorization protocols for Sogroya (growth hormone), Keytruda (immunotherapy), Tafinlar, Mekinist (cancer treatments), and Spravato (depression treatment). Providers must familiarize themselves with expanded coverage criteria including new cancer indications for Keytruda and first-line pancreatic cancer coverage for Tafinlar/Mekinist. Update EMR templates to reflect new documentation requirements, particularly removal of prior treatment history requirements for Spravato and expanded growth chart documentation for Sogroya.