Step therapy, also known as “fail first,” is a tool used by insurers that requires patients to try a less expensive treatment, or series of treatments, before they can access the drug originally prescribed by their physician. Overly burdensome step therapy requirements can jeopardize the patient-provider relationship and unnecessarily prolong ineffective treatment, preventing patients from immediately starting, or in some cases continuing, to access the most appropriate treatment recommended by their doctor. Continue reading Importance of Step Therapy Reform
On Wednesday, January 23, a group of Georgia Advocates gathered at the state capitol building to talk to legislators about step therapy reform. The event was attended by Advocates from across the state,including a mother and daughter who drove from three hours away to talk about the challenges they’ve faced getting access to their medications. The day included a visit from the bill sponsor, Rep. Sharon Cooper (R-43), a brief overview of current step therapy practices and role playing, as well as meetings with some of Georgia’s legislators.
Our Advocates talked to legislators about step therapy, which is an insurance practice that requires patients to use a lower-cost drug before permitting more expensive treatments, despite a physician’s recommendation. Rep. Cooper shared with our Advocates that her bill will create guardrails, allowing a physician to override a step therapy request if the requested medication will negatively react with a medication the patient is already taking, or if the patient has previously tried and failed that drug.
The bill has just been introduced and will go through the Georgia House and Senate chambers for review and votes. Please take a moment to take action by reaching out to your legislators and asking them to support step therapy reform in Georgia.
On May 19, Minnesota Gov. Mark Dayton signed HB 3196 into law! Step therapy legislation gives physicians a clear path toward getting their patients the medications they need.
Having access to affordable, effective and specialized medication is critical for the 54 million Americans living with doctor-diagnosed arthritis nationwide, including over 900,000 in Minnesota. The Arthritis Foundation thanks the bill’s sponsors and Gov. Dayton for helping provide these patient protections to Minnesotans.
Step Therapy is a practice used by insurers that requires people with arthritis to try lower-cost medications before allowing more expensive treatments, despite a physician’s recommendation.
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.
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.
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.
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.
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!