Clinical Guidelines
Embarc Benefit Protection®
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Clinical Information to Establish Medical NecessityEffective 07/15/2021 - 04/02/2023
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Clinical Information to Establish Medical NecessityEffective 10/01/2020 - 07/14/2021
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Hematology - Casgevy™Effective 08/01/2024 - 10/23/2024
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Hematology - Casgevy™Effective 10/24/2024 - 03/31/2025
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Hematology - Casgevy™Effective 04/22/2024 - 07/31/2024
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Hematology - Casgevy™Effective 04/01/2025 - 06/30/2025
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Hematology - Lyfgenia®Effective 04/22/2024 - 03/31/2025
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Hematology - Lyfgenia®Effective 04/01/2025 - 06/30/2025
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Hematology - Zynteglo™Effective 04/01/2025 - 06/30/2025
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Hematology - Zynteglo™Effective 04/22/2024 - 10/23/2024
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Hematology - Zynteglo™Effective 10/24/2024 - 03/31/2025
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Hematology – Zynteglo™Effective 11/15/2022 - 11/16/2023
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Hematology – Zynteglo™Effective 11/17/2023 - 04/21/2024
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Hemophilia - Roctavian®Effective 09/01/2023 - 11/06/2024
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Hemophilia – Beqvez™Effective 01/01/2025 - 04/30/2025
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Hemophilia – Hemgenix®Effective 01/23/2023 - 03/18/2024
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Hemophilia – Hemgenix®Effective 06/04/2024 - 04/30/2025
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Hemophilia – Hemgenix®Effective 03/19/2024 - 06/03/2024
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Neurology - Lenmeldy™Effective 06/04/2024 - 06/30/2025
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Neurology Skysona®Effective 02/15/2025 - 02/28/2025
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Neurology – Skysona®Effective 12/27/2023 - 02/14/2025
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Neurology – Skysona®Effective 11/24/2022 - 12/26/2023
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Ophthalmology - LuxturnaEffective 08/01/2020 - 01/31/2022
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Ophthalmology - Luxturna™Effective 02/01/2022 - 03/26/2024
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Ophthalmology - Luxturna™Effective 03/27/2024 - 04/03/2025
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Spinal Muscular Atrophy - ZolgensmaEffective 08/01/2020 - 09/23/2020
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Spinal Muscular Atrophy - ZolgensmaEffective 12/24/2020 - 10/31/2021
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Spinal Muscular Atrophy - ZolgensmaEffective 11/01/2021 - 04/26/2023
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Spinal Muscular Atrophy - ZolgensmaEffective 11/24/2020 - 12/23/2020
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Spinal Muscular Atrophy - ZolgensmaEffective 09/24/2020 - 11/23/2020
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Spinal Muscular Atrophy - Zolgensma®Effective 04/27/2023 - 11/16/2023
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Spinal Muscular Atrophy - Zolgensma®Effective 11/17/2023 - 12/31/2024