When a doctor prescribes a drug treatment, the patient’s health insurance company may deny coverage and instead require them to try other medications and treatments before they can access that drug. This protocol is known as “step therapy” or “fail first.” Step therapy can help contain prescription drug costs. However, it can also have negative consequences like delayed access to the most effective treatment, severe side effects from inappropriate medications and irreversible disease progression.  

The Safe Step Act would establish reasonable exceptions to step therapy protocols, such as when the required treatment is expected to be ineffective. This legislation would help people living with Parkinson’s access the medications their physicians know will work best for them.  

A drug that contains a radioactive substance, known as a diagnostic radiopharmaceutical, can help diagnose and determine the severity of diseases like Parkinson’s. Unfortunately, Medicare does not always adequately reimburse health care providers for these drugs, so some health care providers choose not to furnish these tests. This can require patients to have to travel far from home for care.   

We urge Congress to pass the FIND Act to require equitable payment for diagnostic radiopharmaceutical drugs, including those used in PET scans and DaTscans, to improve access to these important tools. 

Catching cognitive impairment — a worrisome symptom of neurological diseases like Parkinson’s — is crucial to putting patients on the right treatment path. However, research indicates that cognitive changes often go undetected among older adults. Thankfully, Medicare Part B covers free cognitive impairment assessments as part of preventive care. 

When conducting these assessments, many providers opt to rely on patient observation instead of the more effective structured cognitive assessment tool, which the Centers for Medicare and Medicaid Services (CMS) encourages but does not require. This may result in delayed detection and diagnosis, diminishing opportunities for patients to access timely treatment options and to participate in clinical research. 

The CHANGE Act directs CMS to require health care professionals that provide preventative visits for Medicare to use cognitive impairment detection tools identified by the National Institute on Aging. MJFF urges Congress to advance the bill to improve early detection of Alzheimer’s and related dementias, including Parkinson’s-related dementia and dementia with Lewy Bodies.