On December 13, 2023, Aimed Alliance sent a letter to CMS urging it to place guardrails on step therapy policies in Medicare Advantage Plans. Step-therapy policies, often known as “fail first,” require patients to try and fail on alternative treatments, sometimes causing adverse effects, before the plan will cover the originally prescribed treatment. Such policies can be unethical and inconsistent with standards of care, and can interfere with the patient-provider relationship and compromise patient health outcomes. This letter was prompted by Aimed Alliance previously sending letters to United Health Care, Aetna; and WellCare regarding their use of double-step fail first policies.
Last Updated on December 28, 2023 by Aimed Alliance
