Neurosurgery Urges CMS to Limit Mandatory Step Therapy in Medicare

On April 22, the AANS and the CNS joined a physician coalition letter urging U.S. Department of Health and Human Services Secretary Xavier Becerra to reinstate the step therapy prohibition in Medicare Advantage plans. Specifically, the groups are asking the department to 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. The letter points out that step therapy policies often result “in delayed treatment, increased disease activity, disability and in some cases irreversible disease progression.” The groups also highlighted that step therapy requirements can also be administratively burdensome on physicians and their staff as they help patients navigate complicated and often opaque coverage determination processes.