In step therapy treatment, also known as ‘fail first,’ insurers require patients to try and fail medications before agreeing to cover the initial therapy prescribed by their health care provider.
AGA believes that patients should be given a clear, equitable and transparent appeals process when subjected to step therapy protocols.
What is step therapy?
Each state has different regulations on step therapy, which affects how you can appeal your patient’s care. To educate your and your patients about patient-focused state step therapy laws, AGA has developed a series of videos and podcasts that provide step-by-step directions for how you can use the laws to effectively advocate on behalf of your patients.