AmeriHealth will revise the medical policies on Orencia^® (IV), Actemra^® (IV), and Rituxan^® to update the coverage criteria for the indication of adult rheumatoid arthritis (RA). The criteria apply only to commercial (non-Medicare Advantage) members who have never received a biologic agent as therapy to treat RA. Effective June 3, 2014, Orencia^® (IV), Actemra^® (IV), and Rituxan^® will only be eligible for coverage and reimbursement in the treatment of adult RA when both of the following criteria are met: the member meets the medical necessity criteria in the medical policy for that specific drug; AND the member has a documented failure, contraindication, or intolerance to Remicade^®, or there is a clinical reason that a trial of Remicade^® would be otherwise inappropriate for the member. For members who are currently receiving Orencia^® (IV), Actemra^® (IV), or Rituxan^®, these drugs will continue to be eligible for coverage when they are prescribed in accordance with the regimen that has been precertified by AmeriHealth. Notification versions of the updated medical policies are available online: Medical Policy #08.00.50l: Rituximab (Rituxan^®) Medical Policy #08.00.62e: Abatacept (Orencia^®) for Injection for Intravenous Use Medical Policy #08.00.85d: Tocilizumab (Actemra^®) for Intravenous Infusion For details on these policies, go to our Medical Policy Portal, select Accept and Go to Medical Policy Online, click on Policy Notifications, and then type the policy name or number in the Search box.