On July 1, CVS Caremark updated its prior authorization forms for many biologic drugs. These changes have resulted in an increase to the already overwhelming paperwork burden rheumatology practices face.
The ACR sent a letter to CVS Caremark detailing specific concerns about the prior authorization changes and their impact on rheumatology practices and patients’ timely access to treatment and was able to follow up with a direct phone meeting. Chief among the ACR’s concerns are new criteria regarding the evaluation of treatment efficacy for continuation of therapy requests. CVS Caremark leaders have acknowledged these concerns and committed to revising the forms for a more streamlined and user-friendly process.
ACR will continue to monitor this issue to ensure it is appropriately resolved. We encourage members to contact [email protected] with any questions or concerns.