Umbilical Cord Blood Transplantation - MEDICAID - FLORIDA

This policy covers umbilical cord blood transplantation and related UCB‑derived hematopoietic progenitor cell therapies (e.g., Omisirge/omidubicel, Regenecyte) as a source of hematopoietic stem cells for HSCT. It is intended for individuals with hematologic malignancies or other disorders of the hematopoietic system—typically adults and pediatric patients ≥12 years (policy cites 12–65 years for some indications) planned for UCB transplantation following myeloablative conditioning or when no matched donor is available—but the policy states the evidence is insufficient to define these services as standard care, provides no explicit coverage criteria or prior‑authorization details, and requires administration at an approved treatment facility.

"No specific documentation requirements are specified in the provided excerpt"

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