CLIP: Payers, providers clash on CMS’ plans for step therapy in Medicare Part B

The Alliance of Community Health Plans has asked CMS to allow step therapy policies allowed in the Medicare Part D program to be applied to Medicare Part B, noting the program can prevent overuse of unnecessary services. In a comment letter, ACHP said CMS should extend its policy beyond new prescription starts, allowing MA plan sponsors to offer lower-cost alternatives to members who are already using high-cost medications.

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Learn how ACHP is fighting to lower the cost of prescription drugs