CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Hematology, Endocrinology +2 more·Medical Policy
Effective date
Apr 4, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross is updating coverage criteria for multiple policies effective April-May 2026. Key changes include archiving the Growth Hormone policy, adding continuation therapy criteria for Carfilzomib cancer treatment, and updating detailed coverage criteria for iron homeostasis testing and vitamin B12 testing with specific frequency limitations and covered indications.
Action Required
By April 4, 2026: Billing team must stop submitting claims for Growth Hormone (Policy 1997087) as it will be archived. By May 1, 2026: Update prior authorization protocols for Carfilzomib to include continuation therapy criteria requiring disease response documentation. Update billing system to enforce frequency limits for iron and B12 testing (ferritin max once per month, B12 max once every 3 months). Train staff on new covered indications and ensure proper documentation for medical necessity.