CommercialCoverageLow impact
MP 5.01.28 Treatment for Spinal Muscular Atrophy - Concurrent use of risdiplam with onasemnogene abeparvovec-xioi and/or nusinersen is considered investigational.
Blue Cross of Idaho·ID · Neurology, Pediatrics·Medical Policy
Effective date
Apr 30, 2026
We identified it
Jun 19, 2026
Summary
BCBS Idaho medical policy MP 5.01.28 establishes that concurrent use of risdiplam with onasemnogene abeparvovec-xioi and/or nusinersen for spinal muscular atrophy treatment is considered investigational. This means these drug combinations will not be covered when used together.
Action Required
Before April 30, 2026: Billing team should update system to flag claims for spinal muscular atrophy treatments using risdiplam concurrently with onasemnogene abeparvovec-xioi or nusinersen as investigational/non-covered. Providers should be notified that concurrent use of these medications will not be covered by BCBS Idaho plans.