CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Hematology·Medical Policy
Effective date
Feb 26, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated coverage criteria for lisocabtagene maraleucel (Breyanzi) CAR-T cell therapy, adding new criteria for marginal zone lymphoma and updating existing criteria for large B-cell lymphoma. Three new specialty medications received coverage policies: denileukin diftitox for cutaneous T-cell lymphoma, anti-tissue factor pathway inhibitors for hemophilia, and telisotuzumab vedotin for non-small cell lung cancer.
Action Required
Before February 26, 2026: Oncology and hematology billing teams must update prior authorization processes for Breyanzi (lisocabtagene maraleucel) to include new marginal zone lymphoma criteria requiring at least two prior systemic therapies. Update authorization checklists to verify patients meet updated FDA-labeled indication criteria for large B-cell lymphoma. Add prior authorization requirements for three new medications: Lymphir (denileukin diftitox) for CTCL, Hympavzi/Alhemo for hemophilia, and Emrelis for lung cancer. Claims without proper authorization will be denied.