Step Therapy Programs for Members on the Performance Drug List
Lists drug categories and example prescription drugs that may be subject to step therapy programs under the plan's prescription drug benefit. Explains exception review process and contact instructions.
Provides examples of drug categories and specific medications that may be included in step therapy programs as part of the prescription drug benefit.
Summary of Changes
This bulletin identifies example medications within several therapeutic categories that may be subject to step therapy under the plan's prescription drug benefit and instructs members/providers on exception requests. It notes that the listed drugs are examples and the program is subject to change.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.