Draft Provider-Administered Oncology Policies

To ensure that the development of Blue Advantage oncology policies occurs through an open, collaborative process, we welcome physicians and other providers to submit comments about pharmacy policies that are in the draft stage. We accept comments for 45 days from the posting date listed on the draft policy. Our current draft policies are listed below.

Note: Coverage is subject to member's specific benefits. Group specific policies will supersede these policies when applicable. Please refer to member's benefit plan.


How to Submit Comments

Participating providers can submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to draft policies using one of the following methods:

Comment on Draft Medical Policy

Send comments by mail or fax to:

Blue Cross and BlueShield of Alabama
Attn: Health Management - Medical Policy
P.O. Box 995
Birmingham, AL 35298-0001

Fax: 205-220-0878

Policy # Policy Title Print View
VP-0072 Ixempra® (ixabepilone) (Intravenous)
VP-0098 Denosumab: Prolia®; Xgeva® (Subcutaneous)
VP-0115 Somatuline Depot (lanreotide) (Subcutaneous)
VP-0200 Sylvant™ (siltuximab) (Intravenous)
VP-0209 Keytruda® (pembrolizumab) (Intravenous)
VP-0226 Opdivo® (nivolumab) (Intravenous)
VP-0274 Imlygic™ (talimogene laherparepvec) Intralesional
VP-0314 Vyxeos® (daunorubicin and cytarabine – liposome) (Intravenous)
VP-0367 Elitek® (rasburicase) (Intravenous)
VP-0378 Poteligeo® (mogamulizumab-kpkc) (Intravenous)
VP-0393 Lumoxiti™ (moxetumomab pasudotox-tdfk) (Intravenous)
VP-0426 Elzonris™ (tagraxofusp-erzs) (Intravenous)
VP-0482 Polivy™ (polatuzumab vedotin-piiq) (Intravenous)
VP-0595 Pepaxto® (melphalan flufenamide) (Intravenous)