Highmark Blue Cross Blue Shield September 2017 Medical Policy Updates

Highmark Blue Cross Blue Shield
Highmark Blue Cross Blue Shield

Highmark Blue Cross Blue Shield September 2017 Medical Policy Updates »

September 2017 updated medical policies:

Coverage Criteria Revised for Certolizumab (Cimzia)
Courtesy Update for Tocilizumab (Actemra)
 Criteria Updated for Golimumab (Simponi, Simponi Aria)
Coverage Criteria Revised for Ustekinumab (Stelara)
Coverage Criteria Revised for Carfilzomib (Kyprolis)
Coverage Criteria Revised for Pemetrexed (Alimta)
Coverage Criteria Revised for Abatacept (Orencia) IV and SC
Coverage Criteria Revised for Radium Ra 223 Dichloride for Treatment of Prostate Cancer
Coverage Criteria and Policy Title Revised for PD-1 and PD-L1 Blocking Antibodies
Coverage Criteria Established for Octreotide acetate (Sandostatin, Sandostatin LAR) and Lanreotide (Somatuline Depot)
Revised Coverage Criteria for Wireless Capsule Endoscopy as a Diagnostic Technique in Disorders of the Small Bowel, Esophagus, and Colon
Change in Policy Position for In Vitro Chemoresistance and Chemosensitivity Assays
Revised Criteria for Electromyography (EMG)
Criteria Updated for Upper Gastrointestinal Endoscopy/Esophagoscopy
New Policy Established for Noninvasive Techniques for the Evaluation and Monitoring of Patients with Chronic Liver Disease
Coverage Criteria Updated for Bio-Engineered Skin and Soft Tissue Substitutes
New Policy Established for Total Hip and Total Knee Arthroplasty
Revised Criteria for Eculizumab
Coverage Criteria Revised for Carfilzomib (Kyprolis)
Coverage Criteria Revised for Pemetrexed (Alimta)
Coverage Criteria Revised for Radium Ra 223 Dichloride for Treatment of Prostate Cancer
Coverage Criteria and Policy Title Revised for PD-1 and PD-L1 Blocking Antibodies
Coverage Criteria Established for Octreotide acetate (Sandostatin, Sandostatin LAR) and Lanreotide (Somatuline Depot)
Coverage Criteria Revised for Alpha 1 Proteinase Inhibitor Infusions
Coverage Criteria Revised for Decitabine (Dacogen)
Revised Criteria for Eculizumab

Highmark Blue Cross Blue Shield September 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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