Medicare Bridge Program Prior Auth: Still work in progress at CMS?

[PatchyFog]

So the Medicare Bridge Program starts on July 1st to provide seniors access to GLPs outside of Part D for $50/month and will run for 18 months.

CMS (Medicare's parent) now has a dedicated Bridge Program web page:

Medicare GLP-1 Bridge | CMS

Centers for Medicare & Medicaid Services (CMS) announced the Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) Model and a separate short-term demonstration (now called the “Medicare GLP-1 Bridge”)

www.cms.gov

...but it appears the actual portal/process for a Primary Care Provider to submit a prescription and prior auth to the Bridge Program is still an unavailable work-in-progress at this time.

Does anyone know anything different?

 

[spanky2026]

That's what I've been hearing/reading too, over on a FB group of elderly glp users. Also that some docs are saying they aren't going to even submit, "don't have the staff to handle this," so patients having to find a provider who will. So, pretty much the cluster one would expect.

 

[PatchyFog]

"don't have the staff to handle this," so patients having to find a provider who will. So, pretty much the cluster one would expect.

Yeah. I'm one of those dicks with a concierge Doc, so he'll do what I ask, but doesn't look like the portal/intake process is setup yet. The website says the program is going to be run by Humanna (so I'll bet that goes well!)

 

[sheilarae74]

The website says the program is going to be run by Humanna (so I'll bet that goes well!)

That program is going to be a disaster then.

 

[grandpa_is_healthier]

I almost feel bad for my PHP for what she's going to need to do to with this program

 

[Ted R]

I have about minus 50 percent confidence that the government won't have this whole program totally fuxed up in short order. It's what they do best!