Effective immediately, two CAR T-cell therapies require authorization for Medicare Advantage members

Effective immediately, the following CAR (chimeric antigen receptor) T-cell therapies require authorization for Blue Cross Medicare Plus Blue^SM PPO and BCN Advantage^SM members:

To request authorization for these therapies:

1. Complete the Medication Authorization Request Form on this page for the medication you're requesting.
2. Gather the following supporting clinical documentation:
• The member's eligibility for autologous hematopoietic stem cell transplant
• Testing for CD19 tumor expression
• Previous gene therapy
• Detailed information about the therapies the member has already received
3. Fax the completed form and the clinical documentation to 1-866-392-6465.

Since these requests require thorough review, we ask that you request an expedited review only if the standard review time frame could place the member's health in serious jeopardy.

Posted: March 2018
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network