CommercialPrior AuthMedium impact
Drug Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Nephrology, Oncology, Urology·Pharmacy
Effective date
Mar 31, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated drug policy criteria for two specialty medications: Empaveli (for kidney conditions) now requires laboratory values within 3 months and specific prescriber specialties, while Zejula (for prostate cancer) requires documentation that the patient hasn't progressed on prior hormone therapy per NCCN guidelines.
Action Required
By March 31, 2026: Providers prescribing Empaveli must obtain laboratory values (proteinuria or UPCR) within 3 months prior to initiation and ensure appropriate prescriber specialty for C3G or IC-MPGN cases. By April 1, 2026: Providers prescribing Zejula for prostate cancer must document that patient has not progressed on prior novel hormone therapy per NCCN guidelines. Update prior authorization request templates to include these new documentation requirements.