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 15, 2020

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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