Academy-Led Group to CMS: End Step Therapy in Medicare Advantage
We continue to sound the alarm about the harm caused by elimination of the ban on step therapy for Part B drugs in Medicare Advantage plans.
Member exclusive - Locked
November 8, 2021
Zirabev, Mvasi May Not Be Used to Treat Eye Disease, CMS Says
CMS has told Medicare Advantage plans that the two biosimilars, which are not clinically proven to treat eye disease and are potentially dangerous to ophthalmology patients, may not be used as substitutes for Avastin or be required in their step therapy programs.
June 15, 2021
Avastin Update: CMS, Medicare Payers Urged to Halt Step Therapy
As concern grows about Avastin shortages, the Academy and the American Society of Retina Specialists this week are pushing health plans to halt step therapy and prior authorization requirements imposed on alternative therapies to avoid further patient care disruption.
Member exclusive - Locked
April 28, 2021
Medicare Advantage Plans With Step Therapy Requirements Threaten Patient Outcomes
At Mid-Year Forum 2021, health care leaders and Academy members discussed the burdens of step therapy and how we can advocate for change within the Biden administration.
Member exclusive - Locked
April 21, 2021
Academy Leads Call to Reinstate Step Therapy Ban for Medicare Advantage
We’re leading a large coalition to lobby federal health agencies.
Member exclusive - Locked
May 22, 2019
New Analysis: CMS’ Step Therapy Plan Draws into Focus
The Academy has new details on fail-first policies in Medicare, including how you can appeal decisions to deny care.
May 15, 2019
BREAKING: CMS Releases Step Therapy Rule; Academy Comments Net Impact on New-Starts Requirement
Our early review of the rule concludes that CMS has agreed to an Academy request that it adjust its definition of new starts of treatment.
January 23, 2019
Academy Leads Coalition Response to CMS’ Unacceptable Medicare Advantage Step Therapy Policies
Our profession continues to spearhead efforts to unfetter access to necessary ophthalmic treatments.
January 2, 2019
Academy Calls for Immediate Halt in CMS’ Implementation of Step Therapy
We’re bringing in the attorneys as we continue to press to halt substantial obstacles between patients and their physicians’ recommended treatment options.
October 3, 2018
Federal Watchdog Warns of Step Therapy’s Troubling Effects, Including Profit-Driven Decisions
Fail-first treatment is bad news for our patients, and now HHS’ Office of the Inspector General is agreeing with our belief
