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August 2018 Medical Policy Updates:
- Adcetris (brentuximab vedotin)
- Calcitonin Gene-Related Peptide (CGRP) Antagonist
- Cimzia (certolizumab pegol for subcutaneous [SC] injection [lyophilized] and SC injection [solution] −UCB)
- Colony Stimulating Factors
- Cyramza (ramucirumab injection for intravenous use)
- docetaxel intravenous (IV) injection
- Empliciti (elotuzumab)
- Growth Stimulating Drugs
- Haegarda (C1 esterase inhibitor) Cinryze (C1 esterase inhibitor)
- Herceptin® (Trastuzumab) Ogivri (trastuzumab-dkst)
- Kadcyla (ado-trastuzumab emtansine for intravenous [IV] injection – Genentech, Inc)
- Kymriah (tisagenlecleucel) suspension for IV infusion
- Not Medically Necessary Services
- Nplate (romiplostim for subcutaneous injection)
- Ocrevus (ocrelizumab)
- Oncology Medications
- Radicava (edaravone)
- Stereotactic Radiosurgery and Stereotactic Body Radiotherapy
- Yervoy (ipilimumab)
- Yescarta (axicabtagene ciloleucel) suspension for IV infusion
Policy Alerts monitors Commercial and Medicare medical policies for changes. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. When reviews occur out of cycle they often go unnoticed. Policy Alerts keeps you updated when Payers make coverage changes to medical policies affecting your business.
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