Step ther­apy

The News & Observer - - Opinion -

U.S. Rep. Ge­orge Hold­ing took a bold step in sup­port of vul­ner­a­ble el­derly and dis­abled pa- tients in North Carolina. He called on the Trump ad­min­is­tra­tion to halt its plan to move for­ward with a dan­ger­ous pol­icy for pa­tients in pri­vate Medi­care Ad­van­tage plans.

The pol­icy is known as “step ther­apy.” It lim­its the med­i­cal treat­ments that pa­tients can re­ceive. The new pol­icy would have dire con­se­quences for some of North Carolina’s sick­est Medi­care pa­tients.

Step ther­apy forces pa­tients to be­gin treat­ment with a drug man­dated by the in­sur­ance com­pany. Physi­cians can only move pa­tients to the treat­ment rec­om­mended by their doc­tor if the ini­tial treat­ment fails – even if the doc­tor be­lieves a dif­fer­ent choice would be more ef­fec­tive for the pa­tient. The Trump ad­min­is­tra­tion is al­low­ing Medi­care Ad­van­tage plans to adopt step ther­apy, be­gin­ning Jan. 1.

By op­pos­ing step ther­apy, Rep. Hold­ing is set­ting aside party pol­i­tics to side with North Carolina’s pa­tients. We ap­plaud this stance, be­cause as oph­thal­mol­o­gists, we know that sick pa­tients – es­pe­cially those fac­ing per­ma­nent blind­ness – don’t have the time for wai­t­and-see treat­ment poli­cies. We urge oth­ers in Congress to join Rep. Hold­ing in sup­port­ing pa­tients over pol­i­tics, and push back against step ther­apy in Medi­care Ad­van­tage.

– Kath­leen G. Gor­don, MD Pres­i­dent, NC So­ci­ety of Eye Physi­cians and Sur­geons

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