Prior Authorization and Step Therapy for Part B Drugs in Medicare Advantage
Guidance for Prior Authorization and Step Therapy for Part B Drugs in Medicare Advantage issued to replace the
previous memo “Prohibition on Imposing Mandatory Step Therapy for Access to Part B Drugs and Services,”. It also provides new guidance for Medicare Advantage (MA) plans that may use step therapy for Part B drugs, beginning January 1, 2019, as part of a patient-centered care coordination program.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 07, 2018
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