Find everything you need to help your patients understand their health insurance as it relates to medical and pharmacy benefits and policies here.
Medicare Part B Step Therapy
The Centers for Medicare and Medicaid Services (CMS) has authorized Medicare Advantage (MA) plans to use step therapy for Part B drugs as part of a patient-centered care coordination program. Step therapy is required, and the definition of medical necessity must be met, for certain higher-cost non-preferred medications. We encourage you to consider prescribing one of the following preferred alternatives (pre-authorization may apply) instead of the non-preferred drugs.