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May 2015

Home infusion therapy increases day supply for life-sustaining medications

Blue Cross Blue Shield of Michigan’s home infusion therapy benefit currently allows up to a seven-day supply of medication (10 day supply if a holiday weekend is involved). However, this supply limitation may not be sufficient for life-sustaining infusions. (A life-sustaining infusion medication is one where if the infusion is stopped for any reason, the patient would require immediate hospitalization or the stoppage could lead to loss of life.)

Therefore, effective May 1, 2015, Blue Cross will allow an initial 30-day supply to be dispensed for the life-sustaining infusion medications listed below. Blue Cross will then allow an additional 15 day supply every 15 days. This will provide a large enough supply of infusion in the patient’s home to cover any interruption of delivery that may occur due to natural or unnatural causes.

Life-sustaining infusion medications (24/7 infusion)**

Brand name

Generic name

Flolan®

epoprostenol sodium

Veltri®

epoprostenol sodium

epoprostenol sodium

epoprostenol sodium

Remodulin®

Remodulin®

**This list of drugs will be updated as additional drugs are identified as life-sustaining infusion medications (24/7 infusions) by Blue Cross Blue Shield of Michigan.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
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