CommercialPrior AuthHigh impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·Oncology, Hematology, Rheumatology +2 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Effective April 1, 2026, Walmart insurance will require prior authorization for all Bevacizumab, Infliximab, and Rituximab products (brand and biosimilars) across oncologic and non-oncologic indications. The policy establishes preferred biosimilar products (Mvasi, Zirabev, Avsola, Inflectra, Truxima, Riabni) that must be requested first, with non-preferred products (including Avastin, Remicade, Rituxan) requiring documented adverse events and FDA MedWatch reporting for exceptions.
Action Required
By April 1, 2026: Billing team must update prior authorization systems to require approval for all Bevacizumab, Infliximab, and Rituximab products. Update encounter forms and EMR templates to indicate preferred biosimilars (Mvasi, Zirabev, Avsola, Inflectra, Truxima, Riabni) must be requested first. Train providers on new exception criteria requiring FDA MedWatch reporting for non-preferred products. Claims submitted without prior authorization will result in administrative denials.