CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Hematology, Pulmonology +1 more·Medical Policy
Effective date
Apr 15, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated coverage criteria for multiple specialty medications including oncology drugs, asthma treatments, and CAR-T cell therapy. Key changes include new continuation criteria for several cancer drugs, updated preferred/non-preferred product lists for bevacizumab biosimilars, and one policy (Moxetumomab) being archived.
Action Required
By April 15, 2026: Billing team must update prior authorization requests to reflect new continuation criteria for Enfortumab Vedotin, Romidepsin, Naxitamab, and Reslizumab. Update billing system to prioritize preferred bevacizumab biosimilars (Mvasi Q5107, Zirabev Q5118) over non-preferred products. Stop billing for Moxetumomab (Lumoxiti) as policy will be archived. Ensure documentation requirements for tumor response and clinical improvement are met for continuation approvals.