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Government Advocacy

April 10, 2020: MGMA asks CMS to encourage MA and Part D plans to relax PA and step therapy requirements during COVID

Advocacy Letter

April 10, 2020

Administrator Seema Verma
Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
7500 Security Blvd.
Baltimore, MD 21244-1850

RE: Prior Authorization and Step Therapy Processes

Dear Administrator Verma,

On behalf of the millions of Americans living with chronic, disabling, and life-threatening medical conditions, the undersigned patient and provider organizations have joined together to express our concern regarding the ongoing burdensome prior authorization (PA) requirements administered by Medicare Advantage and Part D Plans. During this time of a pandemic, physicians have less resources and time at their disposable to manage multiple PAs. With so much uncertainty patients should not be worried about whether or not they can access a necessary treatment or service. Therefore, we call on the Centers for Medicare and Medicaid Services (CMS) to encourage Medicare Advantage and Part D plans to relax PA and step therapy standards for medically necessary prescribed or ordered treatments and services during national pandemics.

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