Advocacy & Practice Updates — Clinical Updates
ASRS Advocacy Prompts CMS to Recommend MA Plans Suspend Avastin-First Step Therapy Policies
This afternoon, ASRS received word that CMS has issued a memo to Medicare Advantage (MA) plans encouraging them to suspend Avastin-first step therapy policies temporarily. This memo is a direct result of a letter sent and a subsequent meeting ASRS and AAO had with CMS to educate them on the difficulty retina practices are having obtaining repackaged Avastin following Pine Pharmaceutical’s exit from the market.
In addition, the memo reminds MA plans of their obligation to respond to any expedited step therapy exception request from a physician within 24 hours.
ASRS will follow up with CMS and provide additional details as they become available
(Published 11.25.24)