Medical Policy Updates

Notification of Policy Revisions Effective April 21, 2022 (Posted February 15, 2022)

Policy Name Revised Criteria
Infliximab (Remicade®) and Infliximab Biosimilars Changed diagnosis of neurosarcoidosis to all refractory sarcoidosis; added step through glucocorticoids and methotrexate; updated dosing for sarcoidosis. Policy notification given 2/15/2022 for effective date 4/21/22