Dubuque, IA – New guidelines issued this week by the Center for Medicare and Medicaid Services (CMS) could make it harder for seniors enrolled in Medicare Advantage plans to get drugs chosen for them by their doctors.
After being prohibited by CMS during the Obama administration, new guidelines would allow Medicare Advantage insurers to implement so-called “step therapy,” requiring patients to first try cheaper drugs before being allowed to receive treatments with a higher price tag, even if recommended by their doctors.
This change could impact more than 100,000 Iowa seniors currently enrolled in Medicare Advantage plans.
“This unacceptable plan could result in seniors on Medicare Advantage being denied medications prescribed by their physicians while they are forced to cycle through cheaper options, even if they don’t work as well,” said Abby Finkenauer. “This could have a significant impact on our seniors in Iowa, with over 100,000 of them enrolled in Medicare Advantage plans. This would barely make a dent in drug prices but will result in worse outcomes for seniors – it’s time to get serious about bringing down the cost of prescription drugs by allowing Medicare to negotiate directly with drug companies. Once again our families in Iowa are being forgotten by DC, and since our current leadership won’t stand up for our values, it’s time for a change.”