​​AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively, AmeriHealth) are expanding their Most Cost-Effective Setting (MCES) program to include select oncology immunotherapy drugs. Effective May 1, 2026, the new Oncology Site of Care program will reflect advances in cancer care and support safe delivery of certain immunotherapies in stand-alone infusion centers, providers' offices, or the home. Getting care in these settings can reduce travel and wait times and offer a more comfortable experience for members.

Why immunotherapy

Immunotherapy has changed oncology treatment by teaching the body how to recognize, find, and attack cancer cells. Because immunotherapy uses the body's natural defenses, it is generally less toxic and causes fewer side effects than traditional chemotherapy. Many of these therapies are given through short infusions, which makes them well suited for treatment in a stand‑alone infusion center or in the home.

Immunotherapy drugs included in the expansion to the MCES program

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Key information about the Oncology Site of Care program

• The program will focus on stable adult patients who are receiving a single immunotherapy, rather than traditional chemotherapy.
• There will be clear exception criteria for the program that will allow hospital-based care when patients require closer monitoring.
• Initial doses, clinical instability, combination chemotherapy, and severe toxicities will all be exception criteria utilized in the program.

The Oncology Site of Care program builds on the AmeriHealth existing MCES program guidelines and exception criteria. It is designed to support appropriate and affordable care delivery, not to restrict access. For full program details and requirements, visit the MCES program page that will soon reflect updates on this new program.  

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