Cigna Healthcare Medicare Advantage – Part B step therapy enhancements - Provider Communications

Step therapy is a required process that applies to certain Medicare Advantage Part B prescription drugs. It requires customers to first try preferred medications over nonpreferred medications that treat the same condition. If the preferred medication is proven to be ineffective or causes negative side effects, a nonpreferred medication may then be covered.

As part of our continuing efforts to reduce drug costs while maintaining access for our Cigna Healthcare^℠ Medicare Advantage customers, enhancements have been made to the Part B step therapy program effective July 1, 2024.

Step therapy	Affected drugs	Preferred or nonpreferred?	Part B prior authorization required?	Part B step therapy required?
Viscosupplements	Monovisc^® Orthovisc^® Synvisc^® Synvisc-One^®	Preferred (trial of at least two preferred agents required)	Yes	No
Viscosupplements	Durolane^® Euflexxa^® Gel-One^® Gelsyn-3^® GenVisc 850^® Hyalgan^® Hymovis^® Sodium hyalutonate 1%^® Supartz FX^® Synojoynt^® Triluron^® TriVisc^® Visco-3^TM	Nonpreferred	Yes	Yes

Helpful resources

Part B step therapy quick reference guide
Prior authorization forms
Fax Part B prior authorization and step therapy requests to 877.730.3858.
Call the prior authorization team at 888.454.0013.

Cigna Healthcare Medicare Advantage – Part B step therapy enhancements

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