CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Hematology, Oncology, Cardiology·Medical Policy
Effective date
Feb 19, 2025
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated coverage criteria for multiple specialty medications including gene therapies and cancer treatments. The main change moved active infection screening requirements from coverage criteria to policy guidelines, making providers responsible for ensuring patients don't have active infections before treatment.
Action Required
By February 19, 2025: Providers prescribing Valoctocogene roxaparvovec-rvox (Roctavian), Afamitresgene autoleucel (Tecelra), Imetelstat (Rytelo), Belantamab mafodotin-blmf (Blenrep), or Vutrisiran (Amvuttra) must implement protocols to screen for active infections before treatment. Update EMR templates to include infection screening documentation. Hematologists and oncologists should review updated coverage criteria for these specialty medications to ensure proper patient selection and documentation.