Top Tweets for #MedicareBridge

15 days ago

Happening today 1-2pm ET: TOS Grand Rounds on obesity challenges in older adults with @DianaIsaacs, PharmD & Yael Mauer, MD. Join us: https://t.co/yt9wbUhTUM #ObesityMedicine #OlderAdults #TheObesitySociety #MedicareBridge

ObesitySociety's tweet photo. Happening today 1-2pm ET: TOS Grand Rounds on obesity challenges in older adults with @DianaIsaacs, PharmD & Yael Mauer, MD. Join us: https://t.co/yt9wbUhTUM #ObesityMedicine #OlderAdults #TheObesitySociety #MedicareBridge https://t.co/Zok6EmkBjk

596

OAC

@ObesityAction

3 months ago

Questions or delays with Medicare GLP- 1 Bridge Program? You're not alone. Visit OAC's Resource Hub for practical guidance and patient resources. https://t.co/znXN5n3YKX #MedicareBridge #AccessToCare #OAC

ObesityAction's tweet photo. Questions or delays with Medicare GLP- 1 Bridge Program? You're not alone. Visit OAC's Resource Hub for practical guidance and patient resources. https://t.co/znXN5n3YKX

#MedicareBridge #AccessToCare #OAC https://t.co/LsEf9FjHgR

565

On The Pen™

@ManOnThePen

3 months ago

GLP-1 #MedicareBridge Prior Authorization CMS released prior the authorization request form for the GLP-1 bridge program a couple weeks back. One of the more interesting things buried inside the Medicare GLP-1 Bridge Program prior authorization form is what it tells us about who this program is actually designed to help. Right out of the gate, the form makes it clear that patients with certain Medicare Part D eligible diagnoses are expected to pursue coverage through their Part D plan rather than through the bridge program itself. That includes people with moderate to severe obstructive sleep apnea, MASH with moderate to advanced fibrosis, type 2 diabetes, and those using a GLP-1 medication to reduce cardiovascular risk in the setting of established cardiovascular disease. In other words, the bridge program appears to be focused primarily on people seeking treatment for obesity who do not already qualify for Medicare coverage through another approved indication. While none of these observations are especially surprising given what we already know about Medicare coverage pathways and obesity treatment, the form does provide some useful confirmation of how the program is expected to operate in practice. In that sense, it serves less as a source of new information and more as a helpful reminder of the eligibility distinctions and administrative steps that may shape patient access. There is also a procedural requirement that patients should know about. Before a physician can even submit a prior authorization request, there must first be a denied pharmacy claim submitted through the GLP-1 Bridge Program processing system. That may sound like a small detail, but it could become an important source of confusion or delays if providers are unfamiliar with the process. In practical terms, that likely means a provider would first send a prescription for an eligible GLP-1 medication to a participating pharmacy, which would then process the claim using the bridge program’s billing information. Because the patient has not yet been approved, the claim would be expected to reject or deny. That denial then creates the record needed before the prior authorization request can move forward. Patients may want to confirm that their physician’s office and pharmacy understand this step, since skipping it or processing the prescription incorrectly could potentially delay access to the program.

Top Tweets for #MedicareBridge

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