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Medical Injectables Program Updates: February 2020

In February 2020, the injectable medications listed below will be included as part of our Medical Injectables Program (MIP).

  • Beginning with services to be provided on and after February 1, 2020, Magellan Rx Management will conduct medical necessity and appropriateness reviews (MNARs) for the following additional injectable medications as part of the MIP.¹
BRAND NAME GENERIC NAME HCPCS
Infugem gemcitabine J9199
Beovu® brolucizumab-dbll J0179
Polivy™ polatuzumab vedotin-piqq J9309

Review the full list of injectable medications that require MNAR as part of the MIP, or learn more about our Medical Injectables Program.

If you have questions, please contact your Network Specialist.

¹As part of our MIP, Magellan Rx Management conducts MNARs for injectable medications administered in a freestanding or hospital-based dialysis center, an outpatient facility, a patient’s home or a physician’s office. Magellan Rx Management does not conduct MNARs for injectable medications administered during an inpatient stay, or in an Emergency Room or Observation Room setting.

For medical Injectable services rendered in the patient’s home, call
1-855-243-3321 for participating Horizon Care@Home health care professionals to obtain pre-service determination.

Magellan Rx ManagementSM is a service mark of Magellan Health, Inc. Magellan Rx Management is an independent company that supports Horizon Blue Cross Blue Shield of New Jersey in the administration of conduct medical necessity and appropriateness review (MNAR) for certain medical injectable drugs. Magellan Rx Management is independent from and not associated with Horizon Blue Cross Blue Shield of New Jersey.

This document contains prescription brand name drugs that are registered marks or trademarks of pharmaceutical manufacturers that are not affiliated with Magellan Rx Management, Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association.

Published on: December 30, 2019, 02:12 a.m. ET
Last updated on: December 24, 2019, 04:29 a.m. ET