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Draft Provider-Administered Oncology Drug Policies

Draft policies are listed below. If there are no policies listed, it means there are currently no policies in draft status.


Note: Coverage is subject to member's specific benefits. Group specific policies will supersede these policies when applicable. Please refer to member's benefit plan.

Comment on Draft Oncology Drug Policies

Participating providers are invited to submit for consideration scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to draft policies.

Comments are accepted for 45 days from the posting date listed on the draft policy.

Make sure your voice is heard by providing feedback directly to us:

Birmingham Service Center
Attn: Health Management — Medical Policy
P.O. Box 10527
Birmingham, AL 35202

Fax: 205-220-0878

Draft Policies

Policy # Policy Title Print View
VP-0336 Cinvanti™ (aprepitant) (Intravenous)
VP-0378 Poteligeo® (mogamulizumab-kpkc) (Intravenous)
VP-0503 Reblozyl® (luspatercept-aamt) (Subcutaneous)
VP-90055 Halaven® (eribulin)
VP-90074 Cabazitaxel: Jevtana®; Cabazitaxel§
VP-90156 Synribo® (omacetaxine mepesuccinate)
VP-90166 Torisel® (temsirolimus)
VP-90205 Beleodaq® (belinostat)
VP-90216 Folotyn® (pralatrexate)
VP-90256 Onivyde® (irinotecan liposome injection)
VP-90321 Aliqopa® (copanlisib)
VP-90336 Cinvanti® (aprepitant)
VP-90378 Poteligeo® (mogamulizumab-kpkc)
VP-90423 Infugem™ (gemcitabine)
VP-90425 Asparlas® (calaspargase pegol-mknl)
VP-90503 Reblozyl® (luspatercept-aamt)
VP-90722 Talvey™ (talquetamab-tgvs)
VP-90724 Elrexfio™ (elranatamab-bcmm)