VA Gov. Northam Signs Step Therapy Reform Bill Into Law
On Tuesday, March 12, Virginia joined the ranks of 22 states that have passed legislation to curb step therapy. House Bill 2126, which was signed into law by Virginia Gov. Ralph Northam, reforms step therapy, or “fail first,” insurance protocols that force patients to try and fail an insurer-preferred medication before the medication their doctor originally prescribed. This legislation places important guardrails to protect patients from the inappropriate use of burdensome step therapy protocols.
Patients and providers have been working hand in hand on reforming step therapy protocols in Virginia since 2016. Countless touchpoints with legislators have gotten us across the finish line, including letters sent to legislators, op-eds published in local newspapers, coalition-based initiatives through Fair Health Care VA and even state legislative days with in-person legislator meetings in Richmond.
Dr. Harry Gewanter, Arthritis Foundation Ambassador and chair of the Virginia advocacy committee, played an instrumental role in the success of this bill. Of the step therapy win, Dr. Gewanter says: “This legislation will help patients receive appropriate therapies when their unique circumstances need personalized treatment and ensure that the patient-physician relationship remains at the center of care decisions.”
The Arthritis Foundation thanks all legislators who have supported the bill, specifically Delegate Davis, who has championed this bill for four years. You can share your gratitude with the legislature as well!
If you have a step therapy story, we want to hear from you.
You can learn more about advocacy and amplifying your voice by becoming an Arthritis Foundation Advocate! Sign up today!
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.
Continue reading MN Governor Dayton Signs Legislation for Step Therapy Guardrails
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!