Effective January 16, 2023, Independence Blue Cross and Independence Administrators will update their medical policy on insertion of implantable infusion pumps for Commercial and Medicare Advantage members.
For Commercial members, medically necessary criteria will be updated for the treatment of chemotherapy for cancer and for opioid drugs for chronic intractable pain.
For Medicare Advantage members, medically necessary criteria will be updated for administration of continuous subcutaneous insulin for the treatment of diabetes mellitus. Not medically necessary criteria will be added for external infusion pump and related drugs and supplies in the home setting for the treatment of thromboembolic disease and/or pulmonary embolism by heparin infusion.
For more information, view the notifications for the following policies, which were published on December 16, 2022, and December 19, 2022: