Advocacy News

The Academy met with the Center for Medicare & Medicaid Services and other physician and patient groups to ask the agency to reinstate a step therapy prohibition for Medicare Advantage plans for Part B drugs.      

Nine out of 10 physicians surveyed by the American Medical Association said for patients whose treatments required prior authorization, the process had a somewhat or significant negative effect on their clinical outcomes. The Academy continues to work with our members and partners to press for reform.

We’re concerned that new national standards would override state scope-of-practice laws and other veterans’ patient safety policies.

We continue to sound the alarm about the harm caused by elimination of the ban on step therapy for Part B drugs in Medicare Advantage plans.

CMS has told Medicare Advantage plans that the two biosimilars, which are not clinically proven to treat eye disease and are potentially dangerous to ophthalmology patients, may not be used as substitutes for Avastin or be required in their step therapy programs.

Congress’ deal infuses $3 billion into the physician payment system to reduce the negative effect of the policy changes for evaluation and management (E/M) services that the Centers for Medicare & Medicaid Services (CMS) will implement in January.

A recent Academy survey indicated that 13% of our members now say they use telehealth services to treat patients.