Physician Practice Roundup—25 physician and patient groups urge CMS to implement proposed step therapy safeguards

Young female doctor sitting at desk in front of computer covering face with hand in frustration
Physician and patient groups want to see patient protections in place for step therapy. (Getty Images/PRImageFactory)

25 physician and patient groups urge CMS to implement proposed step therapy safeguards

In a letter sent yesterday, 25 physician and patient groups urged the Centers for Medicare & Medicaid Services (CMS) to immediately implement proposed step therapy safeguards to protect patient access to needed treatments.

The coalition, led by the American College of Rheumatology, also urged CMS to provide additional protections for patients. The coalition said CMS should immediately add patient safeguards that are part of its proposal allowing Medicare Advantage plans to use step therapy for Part B drugs.

The safeguards are set to take effect in 2020, but the groups urged CMS to immediately publish guidance to insurance plans that would provide protections in 2019. “The proposed guardrails would not go into effect until 2020, leaving vulnerable patients from harmful step therapy practices. For patients with severe or complex diseases, this can result in irreversible damage, disability and even death,” the groups wrote in the letter to CMS Administrator Seema Verma. (Coalition letter (PDF))

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