Immunology/Rheumatology policy updates
Track new and updated Immunology/Rheumatology policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Medical specialty medication quantity limits (selected agents) | Aetna | Clinical | Immunology/Rheumatology | Modified | Apr 1, 2026 |
| Medical Specialty Medication Quantity Limits — Maximum Dosing Regimens | Aetna | Clinical | Immunology/Rheumatology | Modified | Jan 1, 2026 |
| Medical Specialty Medication Quantity Limits — Maximum Dosing Regimens and Quantity Limits (Actemra and multiple specialty medications) | Aetna | Clinical | Immunology/Rheumatology | Modified | Oct 1, 2025 |
| Golimumab (Simponi and Simponi Aria) | Aetna | Clinical | Immunology/Rheumatology | Modified | Jul 10, 2009 |
| Golimumab (Simponi and Simponi Aria) coverage | Aetna | Clinical | Immunology/Rheumatology | Modified | Jul 10, 2009 |
| Hereditary Angioedema | Aetna | Clinical | Immunology/Rheumatology | Modified | Apr 10, 2009 |
| Rilonacept (Arcalyst) coverage | Aetna | Clinical | Immunology/Rheumatology | Modified | Nov 21, 2008 |
| Certolizumab Pegol (Cimzia) | Aetna | Clinical | Immunology/Rheumatology | Modified | Aug 8, 2008 |
| Abatacept (Orencia) | Aetna | Clinical | Immunology/Rheumatology | Modified | Mar 17, 2006 |
| Adalimumab (Humira and biosimilars) | Aetna | Clinical | Immunology/Rheumatology | Modified | Mar 25, 2003 |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
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Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.