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CVS Issues Revised Prior Authorization Forms

  |  Issue: June 2022  |  

CVS Caremark has issued revised prior authorization forms in response to ACR and provider concerns about administrative burden.

In July 2021, CVS Caremark changed its prior authorization forms for many biologic drugs, creating an increased administrative burden for rheumatology practices. The ACR received many complaints about the changes, which included new criteria around the evaluation of treatment efficacy for continuation of therapy requests. ACR leaders have had several conversations with CVS representatives and relayed these concerns. In April, CVS responded by issuing a streamlined version of the forms. 

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ACR is continuing to monitor this issue to ensure it is appropriately resolved and the burden on practices is reduced. We encourage members to contact [email protected] with any questions or concerns.

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