Precertification requirements for the drugs Spinraza (nusinersen) and
Bavencio (avelumab) are changing, as follows:
- For AmeriHealth Pennsylvania members, precertification requirements for
both drugs went into effect as of April 19, 2017.
- For AmeriHealth New Jersey members, precertification requirements for
both drugs will go into effect on August 1, 2017.
We are in the process of updating the medical policy that addresses
Bavencio. In the interim, requests for Bavencio will be evaluated in accordance
with the manufacturer?s prescribing information and the U.S. Food and Drug
Administration labeling.
Review Medical Policy #08.01.36: Nusinersen (Spinraza™) for more
information about Spinraza.
To view this policy, go to the Medical Policy Portal,
select Accept and Go to Medical Policy Online, then select
Commercial, and type the policy name or number in the Search field.
A comprehensive list of all drugs and services that require precertification is
available online for
AmeriHealth New Jersey and
AmeriHealth
Pennsylvania.