Welcome

Blue Cross Blue Shield of Massachusetts and Carelon recognize the key role medical oncology practices play in the delivery of high-value, high-quality cancer care. We also recognize the challenges you may face both in keeping current with treatment advances and ensuring cost-effective care for your patients. Together, we are implementing a program to promote evidence-based, high-value care for members undergoing medical oncology treatments. This site was developed to support your oncology practice as you participate in the medical oncology program. For the Radiation Oncology Program, click here.

When your practice prescribes a cancer treatment regimen and submits it for review, it is compared against evidence-based, optimal Cancer Treatment Pathways, while simultaneously ensuring prescribed regimens are aligned with Blue Cross Blue Shield of Massachusetts’ medical policy or CMS Coverage Determinations (applicable for Medicare Advantage members). In cases where the planned regimen is not aligned with an identified Pathway, information on alternatives may be presented but are not required for submission.