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Neurosurgery Urges CMS to Limit Step Therapy in Medicare

On Nov. 23, the AANS and the CNS signed a letter asking CMS to reinstate the step therapy prohibition in Medicare Advantage plans. In the letter, the groups requested that the agency prohibit step therapy for Part B drugs as specified in the original Sept. 17, 2012, memo “Prohibition on Imposing Mandatory Step Therapy for Access to Part B Drugs and Services.” Step therapy, also known as “fail first,” is utilized by health plans to determine coverage and requires that patients fail on an insurer’s preferred medication before the therapy prescribed by their health care provider is covered.

Click here to read the letter.