Fighting Back on CMS “Fail First” for Medicare Advantage Patients

April 22, 2021
The AAAAI has joined more than fifty other organizations in an April 22, 2021 letter asking the Biden Administration to reverse an executive action in 2018 that removed patient protections from “fail first” treatment requirements for Medicare Part B patients.

September 26, 2018
As the Administration continues to move forward with the recent policy change that would allow Medicare Advantage (MA) plans to use step therapy, the AAAAI with others asks that the Administration be mindful of the potential impact on beneficiaries and to implement further safeguards that will assure patient care is not negatively impacted. Read more.

September 7, 2018
The AAAAI has signed on to a letter communicating with both CMS and Members of Congress about a CMS decision announced in August to reverse long-standing policy prohibiting Medicare Advantage (MA) plans from using step therapy for Part B covered drugs, unless also required in Medicare fee-for-service. This change, announced without the standard proposal and comment process, will likely increase out of pocket costs for many patients, and decrease physician ability to direct the care of the most vulnerable patients, such as those with immunodeficiency diseases. The AAAAI also joined an AMA letter to CMS on the issue.