CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Hematology, Oncology, Endocrinology +1 more·Medical Policy
Effective date
Mar 30, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated three policies effective March 30, 2026: added four new medications (Esketamine, Furosemide, Plozasiran, and Sibeprenlimab) to the self-administered medication list, expanded Beta-thalassemia coverage criteria for Casgevy to include patients receiving ≥10 units packed red blood cells per year, and modified Lyfgenia coverage to allow patients with non-melanoma skin cancer history.
Action Required
By March 30, 2026: Billing team must update prior authorization systems and billing software to reflect new self-administered medication list including Esketamine (J0013), Furosemide (J3490), Plozasiran (J3490), and Sibeprenlimab (J3590). Update gene therapy coverage criteria in system for Casgevy and Lyfgenia treatments. Review full policy documents at provided Arkansas Blue Cross links for complete coverage requirements.