New Studies Underscore Doctor, Patient Burden of PA in Medicare Part B
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Jul 03, 2025
As insurers pledge to reduce the number of medical procedures subject to prior authorization (PA), industry experts say those efforts could trickle down to prescription drugs. According to Avalere Health research, Medicare Advantage plans’ increasing reliance on step therapy (ST) for Medicare Part B-covered therapies has become particularly burdensome for patients and providers, highlighting one potential reform target. But a policy banning its use was reversed by CMS during Donald Trump’s first presidency, and an effort to undo that during the Joe Biden administration did not pan out.
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