Goal: To ensure appropriate
prescriptive treatment for patients based on a physician’s recommendation.
- Allow
physician override of the step therapy sequence when deemed medically
necessary and in the best interest of the patient.
- If
a patient is currently stable on a drug, step therapy cannot be required
to continue usage of that drug due to a change in the patient’s health
care benefit or plan.
- Shorten
the amount of time to grant a step therapy override.
