Medicare AdvantageCoverageMedium impact
MA08.136f, Dostarlimab-gxly (Jemperli)
Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
May 19, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated the medical necessity criteria for Dostarlimab-gxly (Jemperli), a pharmacy benefit drug. This change affects prior authorization requirements or coverage criteria for this oncology medication, effective May 19, 2025.
Action Required
By May 19, 2025: Billing and clinical teams must review updated medical necessity criteria for Dostarlimab-gxly (Jemperli) prescriptions. Update prior authorization workflows and ensure documentation meets new criteria requirements. Verify coverage requirements in billing system for Medicare Advantage patients receiving this oncology treatment.