Medical Policy Updates

Notification of Policy Revisions Effective June 8, 2010 (Posted March 2, 2010)

Medical Policy	Revision
Anterior Eye Segment Optical Imaging OTH8021	Notification of new policy. Scanning computerized ophthalmic (e.g., OCT) imaging of the anterior eye segment is considered investigational. Notification given 3/2/2010. Effective date 6/8/2010.
Tocillizumab (Actemra)	New medical policy issued. Tocilizumab (Actemra®) may be medically necessary for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more TNF antagonist therapies. Notification date 3/02/10 for effective date of 6/08/10.
Ustekinumab (Stelara) DRU4177	New policy issued. Ustekinumab (StelaraTM) may be considered medically necessary for the treatment of moderate to severe plaque psoriasis in patients who are 18 years of age or older; and have already been treated with phototherapy (i.e., PUVA or broadband or narrowband UVB) unless the patient is not a candidate for phototherapy or phototherapy is not available to the patient; and have already been treated with or are not a candidate for any other systemic treatments such as methotrexate (oral or IM), cyclosporin, and acitretin (Soriatane®). Notification date 3/02/10 for effective date of 6/08/10.