CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · ENT (Ear, Nose & Throat), Oncology·Medical Policy
Effective date
Jun 15, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross expanded coverage for balloon dilation of the eustachian tube to include pediatric patients ages 8-17 with chronic obstructive ETD, and added a new non-covered indication for genetic expression assays in breast cancer patients considering neoadjuvant therapy.
Action Required
By June 15, 2026: ENT providers and billing teams must review and update prior authorization criteria for balloon dilation of eustachian tube procedures to include new pediatric eligibility (ages 8-17) and comprehensive diagnostic requirements. Update billing software to flag these cases for pre-authorization review. For oncology practices, immediately stop billing genetic expression assays (Oncotype DX, EndoPredict, Breast Cancer Index, Prosigna, Mammaprint) for neoadjuvant breast cancer workup as these are now non-covered.