Provider Update - Prior Authorization & Step Therapy for Part B Drugs
Date: 11/22/18
CMS has rescinded their September 17, 2012 HPMS memo “Prohibition on Imposing Mandatory Step Therapy for Access to Part B Drugs and Services,” and issuing new guidance that recognizes Medicare Advantage (MA) plans may use step therapy for Part B drugs, beginning January 1, 2019, as part of a patient-centered care coordination program.
For additional information see the Provider Update below.
Provider Update - Prior Authorization & Step Therapy for Part B Drugs (PDF)