Step Edit Series
Published Date:
ABOUT THE SERIES
Step edit requirements are increasingly being applied to oncology therapies, creating new challenges for providers, practices, and patients. These payer-imposed policies can delay treatment initiation, limit clinical autonomy, increase administrative burden, and create uncertainty for patients navigating their cancer care journey.
To help oncology professionals better understand and address these barriers, NCODA developed the Step Edits in Oncology Webinar Series. This three-part educational program explores the fundamentals of step edit policies, their impact on oncology care delivery, and practical strategies for navigating payer requirements while advocating for timely, evidence-based treatment access.
Upon completion of this series, participants will be able to:
- Differentiate step edit requirements from other utilization management strategies used in oncology care.
- Evaluate the operational, clinical, and patient-centered impacts of step edit policies.
- Apply practical strategies to navigate payer restrictions, strengthen appeals, and support evidence-based treatment selection.
- Implement multidisciplinary approaches that minimize treatment delays and improve patient access to therapy.
Access the 3-Part Series
Step edit requirements are unfortunately becoming more common in oncology, creating harmful burdens for treatment access and care delivery. Join NCODA’s Step Edits in Oncology Webinar Series to learn about the latest in how this is impacting practices and patients.
This first session in the series will break down what step edits are, how they differ from prior authorizations and other utilization management strategies, and why payers use them. Attendees will gain insight into how Medicare Part D and commercial payers structure step-therapy requirements for treatments, along with the clinical and non-clinical factors that influence payer-mandated sequencing decisions.
Featuring: Melissa Shimanek, PharmD, BCACP (Rocky Mountain Cancer Centers)
Learning Objectives
- Differentiate step edits from prior authorizations and other utilization management strategies.
- Define step edit requirements as they apply to Bruton’s tyrosine kinase inhibitor (BTKi) therapy in oncology.
- Describe how Medicare Part D and commercial payer policies structure step edit therapy for new patient starts.
- Identify clinical and non-clinical factors that influence payer-mandated sequencing of BTKis.
Additional information can be found here.
Step edit policies can have far-reaching negative effects on oncology practice and patient care. In this part-two of the NCODA Step Edits in Oncology Webinar Series we will examine how step-edit requirements influence treatment decisions, workflows, and access to therapy.
Participants will learn more the impact of step edits on oncology care delivery, including prior authorization and appeals workflows, treatment sequencing, and provider autonomy. The session will also address the emotional and financial burdens patients may face when coverage requirements drive therapy changes, as well as how evolving payer alignment trends and federal pricing reforms may affect future access to therapies.
Featuring: Melissa Shimanek, PharmD, BCACP (Rocky Mountain Cancer Centers)
Learning Objectives
- Examine the operational burden of step edits on prior authorization, appeals, and workflow coordination.
- Analyze how step therapy requirements influence treatment sequencing and clinical autonomy.
- Recognize the emotional and financial concerns patients experience when coverage dictates therapy changes.
- Discuss the implications of payer alignment trends and federal pricing reforms on future Bruton’s tyrosine kinase inhibitor (BTKi) access.
Additional information can be found here.
Navigating step edit requirements is unfortunately becoming an essential part of oncology practice. Join us for part-three of NCODA’s Step Edits in Oncology Webinar Series focused on practical strategies to help providers advocate for timely, evidence-based treatment access.
In this session we will explore approaches for managing step edit requirements, including how to strengthen exception requests and appeal submissions using patient-specific clinical documentation. Attendees will also learn multidisciplinary strategies to reduce delays while supporting evidence-based treatment decisions within payer restrictions.
Featuring: Melissa Shimanek, PharmD, BCACP (Rocky Mountain Cancer Centers)
Learning Objectives
- Apply documentation strategies that strengthen step edit exception and appeal submissions.
- Develop a structured appeal process incorporating patient-specific clinical justification.
- Implement multidisciplinary workflows to mitigate delays in Bruton’s tyrosine kinase inhibitor (BTKi) initiation.
- Advocate for evidence-based treatment selection while navigating payer restrictions.
Additional information can be found here.
Explore NCODA’s official position statement regarding step edits and simple ways to advocate for patients.