UnitedHealth, Following Medicare, To Try Step-Therapy

The nation’s largest health insurer, UnitedHealthcare, will use “step therapy” in some of its private Medicare plans next year, requiring patients to try cheaper drugs before trying pricey biologics and other costly medicines. The decision is among the first signs that insurers plan to take advantage of the Administration's initiative that they argue will bring down drug costs for consumers. The recent policy change allows Medicare Advantage plans to use step therapy for Medicare Part B drugs that officials argue will give payers more flexibility and providers say it will lead to unnecessary red tape and more denials. Click here to view UnitedHealthcare's step therapy program guide. 

• A bipartisan group of 103 House members sent a letter to CMS requesting the Agency tell Medicare Advantage plans not to use prior authorization to inhibit beneficiaries' access to services, click here.