Aimed Alliance Urges Medicare Advantage Plans to Stop Imposing Double-Step Fail-First Policies


On August 9, 2023, Aimed Alliance sent letters to Aetna and UnitedHealthcare urging them to reconsider their use of double-step fail-first 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. In both letters, Aimed Alliance urged the plans to eliminate the use of a two-step fail-first policy, which requires patients to try and fail on two separate treatments before being able to access the originally prescribed treatment. Read Aimed Alliance’s letters here and here.

Last Updated on August 16, 2023 by Aimed Alliance


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