Highmark Blue Cross Blue Shield October 2017 Medical Policy Updates

Highmark Blue Cross Blue Shield
Highmark Blue Cross Blue Shield

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October 2017 updated medical policies:

Coverage Criteria Changes for Paclitaxel, albumin-bound, Abraxane
Coverage Criteria Revised for Ziv-aflibercept (Zaltrap)
Criteria Updated for Panitumumab (Vectibix)
Coverage Criteria Revised for Eribulin Mesylate (Halaven)
Criteria Updated for Blinatumomab (Blincyto)
Coverage Criteria Revised for Ramucirumab (Cyramza)
Coverage Criteria Established for Asparaginase Erwinia Chrysanthemi (Erwinaze)
Coverage Criteria Established for Sebelipase Alfa (Kanuma)
Coverage Criteria Revised for Percutaneous Vertebroplasty
Revised Criteria and Policy Title Change for Biventricular Pacemakers for the Treatment of Congestive Heart Failure
New Criteria for Cryotherapy to Treat Barrett’s Esophagus
Coverage Criteria Established for Chimeric Antigen Receptor T-Cell Therapy (CAR-T), Tisagenlecleucel (Kymriah)
New Policy: Medication Assisted Treatment (MAT) for Opioid Use Disorder: Methadone
REMINDER: Molecular and Genomic Testing
New Coverage Criteria and Policy Title Change for Cardiac Computed Tomography (Cardiac CT)
Radiology Management Program Update
Coverage Criteria Established for Abatacept (Orencia) IV
Coverage Criteria Revised for Ziv-aflibercept (Zaltrap)
Criteria Updated for Panitumumab (Vectibix)
Coverage Criteria Revised for Eribulin Mesylate (Halaven)
Criteria Updated for Blinatumomab (Blincyto)
Coverage Criteria Revised for Ramucirumab (Cyramza)
Coverage Criteria Established for Asparaginase Erwinia Chrysanthemi (Erwinaze)
Coverage Criteria Established for Sebelipase Alfa (Kanuma)
Coverage Criteria Established for Chimeric Antigen Receptor T-Cell Therapy (CAR-T), Tisagenlecleucel (Kymriah)

 

Click here to the view the Highmark Blue Cross Blue Shield October 2017 Medical Policy Updates »

 

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

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