CommercialPrior AuthMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Nephrology, Oncology, Hematology +2 more·Medical Policy
Effective date
Jan 15, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated coverage criteria for multiple specialty medications effective January 15, 2026. Key changes include new coverage criteria for Pegcetacoplan (kidney disease), expanded criteria for Emapalumab (blood disorders), updated guidelines for Nogapendekin alfa (cancer), and modified criteria for Rebyota (C. diff infections).
Action Required
By January 15, 2026: Clinical staff must review and update prior authorization documentation requirements for specialty medications including Pegcetacoplan (Empaveli), Emapalumab (Gamifant), Nogapendekin alfa (Anktiva), and Rebyota. Ensure patient charts include all new required clinical criteria, laboratory values, and treatment history documentation before submitting prior auth requests. Review full policy details at provided URLs for complete criteria checklists.