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Arkansas Blue Cross Blue ShieldCommercial · Coverage · Medical Policy · AR · Oncology, Hematology, Pulmonology +1 moreMedium impact

Policy Criteria Change

Act
by Apr 15, 2026
Effective date
Apr 15, 2026
Identified
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.

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What to do

by Apr 15, 2026 · 4 steps
01Billing team must update prior authorization requests to reflect new continuation criteria for Enfortumab Vedotin, Romidepsin, Naxitamab, and Reslizumab.
02Update billing system to prioritize preferred bevacizumab biosimilars (Mvasi Q5107, Zirabev Q5118) over non-preferred products.
03Stop billing for Moxetumomab (Lumoxiti) as policy will be archived.
04Ensure documentation requirements for tumor response and clinical improvement are met for continuation approvals.

Codes mentioned

Q5107Q5118J9035Q5126Q5129J9999

Original notice

Policy Criteria Change
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Related changes

See all Arkansas Blue Cross Blue Shield changes →
Policy Criteria ChangeHighEffective Apr 1, 2026 · Medical PolicyPolicy Criteria ChangeHighEffective Nov 15, 2026 · Medical PolicyPolicy Criteria ChangeHighEffective Oct 28, 2026 · Medical PolicyPolicy Criteria ChangeMediumEffective Nov 15, 2026 · Medical PolicyBrowse every Arkansas Blue Cross Blue Shield change in the policy list

Related policy hubs

Arkansas Blue Cross Blue Shield policiesAR policy changesOncologyHematologyPulmonologyAllergy & ImmunologyCode Q5107Code Q5118Code J9035Code Q5126Code Q5129Code J9999

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