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Blue Cross NC Home Providers Policies, guidelines and codes Notification of Drug Policy Revisions Effective April 1, 2026 Posted January 1, 2026 Notification of Drug Policy Revisions Effective April 1, 2026 Posted January 1, 2026

Medical Drug Policy Name	Revised Criteria
Antiemetic Injection Therapy “Notification” (PDF)	For Akynzeo, added trial and failure of generic palonosetron (Aloxi) as an option to existing required trial and failure of granisetron or ondansetron (oral or IV), or presence of contraindication to granisetron, ondansetron, and generic palonosetron (Aloxi). For Posfrea, added required trial and failure of generic palonosetron (Aloxi). For Focinvez, added required trial and failure of fosaprepitant (Emend). For Sustol, added required trial and failure of granisetron (oral or IV) OR ondansetron (oral or IV) OR generic palonosetron (Aloxi). Removed generic palonosetron (Aloxi) [J2469] and fosaprepitant (Emend) [J1453] from restricted products in policy (now unrestricted). Removed low/minimally emetogenic cancer chemotherapy antiemetic trial and failure requirements where present throughout policy according to FDA labeled use of restricted products. Other minor updates and formatting adjustments made throughout policy for clarity. Policy notification given 1/1/2026 for effective date 4/1/2026.
Familial Chylomicronemia Syndrome Therapy “Notification” (PDF)	Added olezarsen (Tryngolza) to policy for the treatment of adults with familial chylomicronemia syndrome, as an adjunct to diet to reduce triglycerides. For Tryngolza, added to initial and continuation criteria the requirement for trial and failure of Redemplo and the requirement for use of self-administered formulation unless certain criteria are met. Added Tryngolza to SOC criteria and added associated dosing, maximum units, and HCPCS codes C9399, J3490, and J3590 to FDA label reference table. Removed medical record documentation requirements for specialist requirement, concomitant use statement, and verification that secondary causes have been ruled out. Changed policy name to “Familial Chylomicronemia Syndrome Therapy” from “Plozasiran (Redemplo®)”. Policy notification given 1/1/2026 for effective date 4/1/2026.
Omidubicel-onlv (Omisirge®) “Notification” (PDF)	Original medical policy criteria issued. Policy notification given 1/1/2026 for effective date 4/1/2026.