Medicare AdvantageCoverageLow impact
MA08.154a, olipudase alfa-rpcp (Xenpozyme®)
Independence Blue Cross·Endocrinology, Pediatrics·Pharmacy
Effective date
Mar 5, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.154a for olipudase alfa-rpcp (Xenpozyme®) has been reissued and updated. This is a pharmacy policy change affecting coverage or authorization requirements for this enzyme replacement therapy medication used to treat acid sphingomyelinase deficiency.
Action Required
By March 5, 2025: Billing team should review the updated policy MA08.154a on the IBX website to understand any changes to coverage criteria or prior authorization requirements for olipudase alfa-rpcp (Xenpozyme®). Update any internal protocols for prescribing or billing this specialty medication for Medicare Advantage patients.