Peach State Health Plan policy updates
Track new and updated Peach State Health Plan policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Clinical Policy: Etanercept (Enbrel) | Peach State Health Plan | Clinical | Pharmacy & Specialty Drugs | Modified | Aug 16, 2025 |
| Keratoplasty (corneal transplant) | Peach State Health Plan | Clinical | Ophthalmology/Optometry | Modified | Aug 1, 2025 |
| Infusion Therapy Site of Care Optimization | Peach State Health Plan | Clinical | Other | Modified | Jul 25, 2025 |
| Marketplace P4P Program quality measurement and payments | Peach State Health Plan | Reimbursement | Other | Modified | Jan 1, 2025 |
| Glecaprevir/Pibrentasvir (Mavyret) coverage | Peach State Health Plan | Clinical | Pharmacy & Specialty Drugs | Modified | Sep 17, 2024 |
| Peginterferon alfa-2a (Pegasys) Coverage Criteria | Peach State Health Plan | Clinical | Pharmacy & Specialty Drugs | Modified | Aug 26, 2024 |
| Clinical Policy: Abatacept (Orencia) Coverage Criteria | Peach State Health Plan | Clinical | Pharmacy & Specialty Drugs | Modified | Aug 16, 2024 |
| Dupilumab (Dupixent) | Peach State Health Plan | Clinical | Allergy/Clinical Immunology | Modified | Jul 24, 2024 |
| Elbasvir/Grazoprevir (Zepatier) — Coverage Criteria | Peach State Health Plan | Clinical | Infectious Disease | Modified | Jul 20, 2024 |
| Ledipasvir/Sofosbuvir (Harvoni) — Coverage Criteria | Peach State Health Plan | Clinical | Pharmacy & Specialty Drugs | Modified | Jul 20, 2024 |
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.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
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.