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
Imagine going to your healthcare provider and being told that your medication is no longer covered by your insurance. Kim and Gary Kitowski, of Columbia, IL, have faced that reality more than once. Kim, an Arthritis Foundation Ambassador, has lived with arthritis for more than 30 years and her husband, Gary, was diagnosed with multiple sclerosis eight years ago. Because of step therapy, both have fought for access to medications that were prescribed by their doctors.
Continue reading Victory in Illinois! Bill to Curb Step Therapy Signed into Law by Governor Bruce Rauner!
Our advocacy team is incredibly active at the state level, leading the way to make sure that arthritis patients have access to critical medications. Our volunteer Advocates make a significant impact and help achieve tangible results by sharing their stories and asking elected officials to support legislation that is important to them and their families. But beyond fighting for key legislative changes and being vocal in raising awareness and sharing stories that help put faces with arthritis, we also make strides for the arthritis community when we link the voices of patient with the provider community – as we have done recently and successfully in New York and Ohio.
Continue reading Arthritis Foundation Collaborates with Providers at the State Level to Advocate for the Arthritis Community
Update as of June, 2016: A huge victory has occurred in Missouri! House Bill 2029 has been signed by Governor Jay Nixon – thanks to the efforts of our amazing advocates! We are thrilled that Governor Nixon has signed HB 2029 into law. The Arthritis Foundation would like to thank all of the advocates who contacted their legislators and Governor Nixon. Continue reading Step Therapy Bill Makes Huge Progress in Missouri Legislature with Help of Young Advocates
Big news for our arthritis community in Kentucky! On April 13, 2016, Gov. Matt Bevin (R – KY) signed Senate Bill 134 into law. The law creates a pathway for the introduction and use of biosimilars into the mainstream marketplace. Biosimilar medications have the potential to provide safe and effective treatment to people with arthritis at a potentially lower cost than name-brand biologic medications.
The many letters, calls and visits made by Arthritis Foundation Advocates in Kentucky played a significant role in the passage of SB 134.
Continue reading Advocates in Kentucky Get a Big Win for Biosimilar Substitution
West Virginia residents who are living with arthritis have good reason to celebrate. On March 29, 2016, Governor Earl Ray Tomblin signed into law a bill that addresses a growing and concerning insurance industry practice. Commonly known as “step therapy” or “fail first,” some insurance providers began refusing to cover physician prescribed medications, instead insisting that patients first try other less expensive treatments – all to save a buck!
Continue reading West Virginia Advocates Make Strides Against Step Therapy!
For people like Renda Brower, the fight against arthritis and barriers to treatment is an everyday battle. Renda’s husband and two of her children have ankylosing spondylitis. The process to get the medication they need inspired Renda to become an Advocate and to share her story in support of Indiana step therapy bill, Senate Bill 41 (SB41). Today, we celebrate a big victory for the Browers and the 1.3 million people (6,400 of whom are children) in Indiana living with arthritis.
Today, Governor Pence signed into law SB41, putting limits on an insurance industry protocol, known as “step therapy” or “fail first,” which require patients to try and fail medications the insurance provider recommends before they will cover medications as prescribed by their physician. This practice has become pervasive in the insurance industry, even when the prescribed drug is deemed more medically appropriate by the patient’s physician.
Continue reading Victory in Indiana – Fighting Step Therapy