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Medicare AdvantageCoverageMedium impact

MA08.127d, Atezolizumab (Tecentriq®) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza TM)

Independence Blue Cross·Oncology, Hematology·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage updated the medical necessity criteria for Atezolizumab (Tecentriq) and Atezolizumab with Hyaluronidase-tqjs (Tecentriq Hybreza), which are cancer immunotherapy drugs. This change may affect prior authorization requirements or coverage criteria for these medications.

Action Required

Action needed
By January 1, 2025: Review updated medical necessity criteria for Tecentriq and Tecentriq Hybreza prescriptions. Oncology providers should verify current prior authorization requirements and documentation standards have changed. Update any internal protocols for prescribing these immunotherapy medications to ensure compliance with new Medicare Advantage criteria.