On Wednesday, February 28th, New Mexico joined 17 other states across the country in passing legislation to curb step therapy. Senate Bill 11, which was signed into law by New Mexico Governor Susana Martinez, reforms the process that forces patients to try drugs that insurance companies choose, making patients “fail first” before the patient gets to use the medicine that their doctor originally prescribed.
Step therapy is an insurance practice that requires patients to use a lower-cost drug before permitting more expensive drugs – regardless of what your doctor prescribed. This may occur even if you are already taking that pricier medication and doing well on it. Senate Bill 11 placed limits on this practice and helps get the right medicine to patients faster.
Continue reading NM Governor Martinez Signs Senate Bill 11 into Law to Curb Step Therapy
ADVOCACY COMMITTEE REACHES GOAL!
By Amy Barron, Platinum Ambassador, OH Advocacy Committee
I am privileged to serve as a member of the Arthritis Foundation’s Ohio State Advocacy Committee. Advocacy committees like mine help to chart the course of local and state-wide advocacy action for our arthritis community. Many of our committee members serve as Arthritis Foundation Advocates and Ambassadors, at both the state and federal level.
Continue reading Platinum Ambassador Spotlight: Amy Barron, OHIO
From Lori Fagan
I have been living with rheumatoid arthritis (RA) for over a decade. As a full-time working mom and wife living with a chronic condition, the last thing I need is the added strain of fighting with my health insurer.
Unfortunately, because of a common health insurance practice known as “step therapy,” the last 10 years have been a constant and stressful battle.
Continue reading Ambassador Spotlight – Lori Fagan, Virginia
On June 2, Colorado Governor John Hickenlooper signed Senate Bill 203 (SB 203) into law! This important bill stops insurance plans from requiring patients to go through step therapy for their medication if they previously went through step therapy protocols with their current or former insurer.
Continue reading Colorado Passes Law Restricting Step Therapy!
Exciting news in Texas! On May 23, Governor Greg Abbott signed Senate Bill 680 into law, limiting the use of step therapy. Texas now joins a growing number of states that have enacted laws that regulate the use of step therapy. With over 4 million adults and 24,900 kids with doctor-diagnosed arthritis in Texas, this is a major victory!
Step therapy is used by health insurance providers to control the order and use of prescriptions drugs. A patient could be required to try and fail lower-cost or other drugs selected by their insurance provider before coverage is granted for the drug prescribed by the patient’s treating physician. For patients, this barrier to care prevents timely access to doctor prescribed treatments and can be the difference between full mobility and joint damage.
Continue reading Victory in Texas – Legislation Limits Step Therapy
The Iowa arthritis community is celebrating Governor Branstad signing into law House File 233 on May 10, 2017.
The bill, unanimously passed by both chambers, puts limits on an insurance industry protocol known as step therapy which requires patients to try and fail medications identified by the insurance company before agreeing to cover medications prescribed by the treating physician. The bill will increase access to care for arthritis patients by limiting step therapy practices in Iowa.
Continue reading Victory in Iowa! Governor Branstad Signs into Law a Bill to Curb Step Therapy!
Step therapy is a cost saving tactic used by insurers that requires people with arthritis and other potentially debilitating conditions to try and fail lower-cost medications before covering more expensive treatments. In other words, insurance companies oftentimes disregard treating physicians’ knowledge of their patients and related expertise, forcing patients to try cheaper medications, all to save a few dollars.
Continue reading Step Therapy Win in West Virginia!
As we ring in the new year, we celebrate a major step therapy legislative win in New York! An increasing number of health insurers around the country are utilizing fail first or step therapy practices that require patients to try and fail one or more formulary medications before providing coverage for the originally prescribed non-formulary medication. Rather than taking into account the needs of the individual patient, insurers are determining drug sequences based on cost. These practices can vary wildly insurer to insurer with no consistency on how to establish or apply these fail first protocols.
Continue reading New York Step Therapy Reform Legislation Signed into Law by Governor Cuomo