Prior Authorization & Step Therapy For Part B Drugs In Medicare Advantage

This guidance document was released on August 7, 2018, by the Centers for Medicare & Medicaid Services (CMS). It allows Medicare Advantage plans may use step therapy for Part B drugs, beginning January 1, 2019, as part of a patient-centered care coordination program. Step therapy may only be applied to new prescriptions or administrations of Part B drugs for enrollees that are not actively receiving the affected medication . . .