Have you ever gone to pick up a new prescription medication, only to be told your insurance plan won't cover it until you try a different medication first? This requirement is an insurance limit known ...

The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially. Objectives: First, to examine 7 large ...

The authors, both members of the Digestive Health Physicians Association, write about efforts in their home state and at the federal level to reform payer restrictions. As physicians, the health of ...

Step therapy is when Medicare Part D plans ask beneficiaries to try a more affordable drug before approving higher-cost prescriptions. In Medicare, Part D covers general prescription drugs, whereas ...

Every day Melissa Fulton, RN, MSN, FNP, APRN-C, shows up to work, she's ready for another fight. An advanced practice nurse who specializes in multiple sclerosis care, Fulton says she typically spends ...

For people with lupus, their relationship with their healthcare team is one of the most important aspects of managing their life with lupus. Step therapy imposes on that relationship in pursuit of ...

After President Donald Trump announced last week that the federal government will begin negotiating with drug manufacturers for lower prices on medicines paid for by Medicare Part B, discussion has ...

Over the past two decades the use of step therapy or edits by health insurers has increased significantly. Step therapy, also called step edits, implies that in a given therapeutic class lower cost ...