Legislation & Regulation

Discover essential legislative and regulatory resources tailored for managed care pharmacy professionals. Stay informed with the latest updates, policies, and advocacy tools to effectively navigate and influence the health care landscape.

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CMS Notice to Medicare Advantage Organizations on Step Therapy for Part B Drugs

On August 7, 2018, CMS issued guidance to Medicare Advantage (MA) plans acknowledging that step therapy is a recognized utilization management tool. CMS stated that the allowance of step therapy practices for Part B drugs will help achieve the goal of lower drug prices while maintaining access to covered services and drugs for beneficiaries. MA plans will have the choice of implementing step therapy to manage Part B drugs, beginning January 1, 2019.
Medicare Part B, Legislation & Regulation