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Upcoming changes to drug precertification requirements for 2017

October 3, 2016

Effective January 1, 2017, new precertification requirements will apply to our commercial and Medicare Advantage HMO and PPO members for the medical benefit drugs listed below:

  • Cinqair® (reslizumab)
  • Cubicin® (daptomycin)
  • Darzalex™ (daratumumab)
  • Erwinaze® (L-asparaginase)
  • Exondys 51™ (eteplirsen)
  • Faslodex® (fulvestrant)
  • Hymovis® (high molecular weight viscoelastic hyaluronan)
  • Inflectra™ (infliximab)*
  • Neulasta® (pegfilgrastim)*
  • Neulasta® (pegfilgrastim) Onpro®*
  • Sandostatin® LAR (octreotide acetate)
  • Tecentriq™ (atezolizumab)

In addition, the following drugs are currently pending approval from the U.S. Food and Drug Administration (FDA). Once they receive FDA approval, they will also require precertification approval from Independence:

  • Cingal® (sodium hyaluronate/triamcinolone hexacetonide)
  • Ocrevus™ (ocrelizumab)
  • Remune® (HIV-1 immunogen)

These changes will be reflected in an updated precertification requirement list, which will be posted to our website in December, prior to these changes going into effect. Look for more information about the availability of this new precertification requirement list in the December 2016 edition of Partners in Health UpdateSM.

*Precertification requirements apply to all biosimilars of infliximab and pegfilgratism approved by the FDA.

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