HHS Postpones SUNSET Rule Due to Significant Burden on FDA and CMS
On March 19, the Department of Health and Human Services (HHS) announced that it will…
Monthly Archives: March, 2021
CMS Reverses Recent Demonstration Plan That Would Have Allowed Part D Plans to Waive Protected Class and Formulary Requirements in 2022
CMS announced updates to the Part D Payment Modernization Model Calendar Year 2022 (PDM Model),…
Aimed Alliance Launches New York Step Therapy Reform Initiative
Building on the step therapy law that was effective as of 2017, Aimed Alliance has…
Step Therapy Reform: Categorical Exceptions
In 2022, Senator Breslin introduced S8193 and Assemblyman McDonald introduced A9250 which would prohibit the use…
Step Therapy Reform: Increased Reporting and Transparency
In 2022, Senator Breslin introduced S8194 and S8798 and Assemblyman McDonald introduced A9265 and A9206…
Step Therapy Reform: Clinical Peer Review of Step Therapy Decision Making
In 2022, the New York Legislature passed S8113 and A879 which requires a clinical peer-reviewer…
Step Therapy Reform: Strengthening Enforcement and Patient Protections to Deter Step Therapy Violations
In 2022, Senator Breslin introduced S8191, and Assemblyman McDonald introduced A9267 to create additional step-therapy…
Step Therapy Reform: Dermatological Conditions
Requiring patients with dermatological conditions to try and fail alternative treatments before the insurer or…
Step Therapy Reform: Gastroenterological Conditions
Mandating patients with gastroenterological conditions undergo step therapy before the prescribed treatment is covered may…
Step Therapy Reform: Hematological Conditions
Requiring patients to “fail first” on alternative treatments can be particularly harmful and burdensome for…