SHPBN-2018-036 Medicare Part B Step Therapy Guidelines

Date: 12/26/18

Thank you for your continued partnership with Allwell from Sunflower Health Plan. We are writing to inform you of changes to the prior authorization requirements for Medicare Part B medications.

Effective January 1, 2019, some Medicare Part B medications will be subject to step therapy guidelines. The purpose of the step therapy guidelines is to ensure that lower cost medications have been tried before moving on to more expensive drug regimens.

To determine whether your patients are taking medications that are subject to the step therapy program, please use the Pre-Auth Needed tool.

If you have any questions about this program, please don’t hesitate to reach out to Provider Services at 1-855-565-9519.