Have you ever gone to pick up a new prescription medication, only to be told your insurance plan won’t cover it until you try a different medication first? This requirement is an insurance limit known ...

For people with lupus, their relationship with their healthcare team is one of the most important aspects of managing their life with lupus. Step therapy imposes on that relationship in pursuit of ...

The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially. Objectives: First, to examine 7 large ...

The authors, both members of the Digestive Health Physicians Association, write about efforts in their home state and at the federal level to reform payer restrictions. As physicians, the health of ...

FACING EXACTLY THAT HERE IN MASSACHUSETTS UNTIL LAST WEEK. YOU MAY HAVE MISSED THIS IN THE RUN UP TO THE MIDTERMS, BUT GOVERNOR BAKER SIGNED A BILL INTO LAW YEARS IN THE MAKING GIVING MORE CONTROL TO ...

The Centers for Medicare and Medicaid Services recently sent shudders through the specialty drug market by authorizing Medicare Advantage Plans to use step therapy protocols for Part B drugs. The ...

The broader implementation of step therapy in Medicare Advantage could significantly influence the treatment access and experience as well as health outcomes for millions of patients with diverse ...

Please provide your email address to receive an email when new articles are posted on . Step therapy, a controversial payer policy, can cause treatment delays and contribute to physician burnout.

Over the past two decades the use of step therapy or edits by health insurers has increased significantly. Step therapy, also called step edits, implies that in a given therapeutic class lower cost ...

A person holding a vitamin bottle while checking prescription instructions in a smartphone. Have you ever gone to pick up a new prescription medication, only to be told your insurance plan won’t cover ...