The DME MACs Propose Coverage Expansion for Blinatumomab

WASHINGTON—The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) announced they will host a virtual public meeting to solicit stakeholder comments on Aug. 27. The purpose of the meeting is to discuss the expansion of coverage and to clarify the coverage criteria for blinatumomab, an immunotherapy drug used to treat B-cell acute lymphoblastic leukemia (ALL). 

The DME MACs aim to hold open comments for the following proposed local coverage determination (LCD):

• Proposing to expand coverage for blinatumomab to adult and pediatric beneficiaries one month and older with CD19-positive Philadelphia chromosome-negative B-cell precursor ALL in the consolidation phase of multiphase chemotherapy
• To clarify the existing blinatumomab criteria to include the age qualifier of "one month and older" to be consistent with the clinical literature and FDA prescribing information
• To update coverage criteria for infusion-based therapy for the treatment of motor control symptoms associated with Parkinson’s Disease that are inadequately controlled by non-infusion-based therapy
• To add YVALEV J7356 to the Healthcare Common Procedure Coding System (HCPCS) array. YVALEV is a therapy for adults with advanced Parkinson's Disease that delivers a continuous 24-hour dose of medication through a portable programmable pump.

The deadline for stakeholders to submit written comments is Sept. 6, 2025. The open meeting will be held Aug. 27 at 12 p.m. ET.