CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Hematology, Neurology·Medical Policy
Effective date
Feb 1, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated coverage criteria for several medications effective 2/1/2026, including archiving Beremagene Geperpavec-svdt and moving it to self-administered medication policy, expanding Pertuzumab coverage to include age 18+ patients and new off-label indications, updating maximum dosage quantities for medical benefit drugs, and adding two new policies for advanced Parkinson's disease and multiple myeloma treatments.
Action Required
By February 1, 2026: Billing team must update system to reflect new maximum billing units for medical benefit drugs including Tofersen (J1304 - 100 units every 14 days), Alemtuzumab (J0202 - 12 units daily for 5 days per year), and other specified medications. Update Pertuzumab coverage criteria to include patients 18+ years old and new off-label indications. Remove Beremagene Geperpavec-svdt from current billing protocols and reclassify under self-administered medication policy. Review new policies for Foscarbidopa/foslevodopa and Linvoseltamab-gcpt for applicable patients.