New regulations from Centers for Medicare and Medicaid Services (CMS), an arm of the U.S. Department of Health and Human Services, puts new regulations on the private Medicare drug plan market to move towards use of cheaper drugs first.
Referred to as “step therapy,” the push towards using the cheaper drugs first before more expensive alternatives are tried has been part of the regulations in the past but was not preferred by providers or patients. According to an article from ThinkAdvisor, “CMS says it will speed up its process for handling patient appeals related to the kinds of drugs affected by the new rules.” This will hopefully alleviate the concerns from previous attempts at moving towards a step therapy policy.
A preliminary version of the final Medicare Part D and Medicare Advantage drug price regulations is available here.
For help understanding this and other changes in the Medicare marketplace, contact the Medicare insurance brokers at Steinlage Insurance Agency.