Advocacy News

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.

As concern grows about Avastin shortages, the Academy and the American Society of Retina Specialists this week are pushing health plans to halt step therapy and prior authorization requirements imposed on alternative therapies to avoid further patient care disruption.

At Mid-Year Forum 2021, health care leaders and Academy members discussed the burdens of step therapy and how we can advocate for change within the Biden administration. 

We’re leading a large coalition to lobby federal health agencies.

The Academy has new details on fail-first policies in Medicare, including how you can appeal decisions to deny care.  

Our early review of the rule concludes that CMS has agreed to an Academy request that it adjust its definition of new starts of treatment.

Our profession continues to spearhead efforts to unfetter access to necessary ophthalmic treatments.  

We’re bringing in the attorneys as we continue to press to halt substantial obstacles between patients and their physicians’ recommended treatment options.

Fail-first treatment is bad news for our patients, and now HHS’ Office of the Inspector General is agreeing with our belief