State legislative sessions across the country are now in full swing! Here are some major trends we’re seeing related to state pain policy, along with opportunities to take action. You can find all of our opportunities to act here. More will be added soon!
Affordable access to multidisciplinary care
An increasing number of states are looking for ways to expand affordable access to multidisciplinary pain management options, like massage, acupuncture, physical therapy, occupational therapy, and chiropractic care.
Patient and provider groups are celebrating the introduction of the “Safe Step Act,” a federal bill aimed at lessening treatment delays and barriers to the access of prescription therapies. Filed by Representatives Raul Ruiz (D-CA) and Brad Wenstrup (R-OH), HR 2279 would reform the potentially harmful insurer practice known as step therapy, which allows insurers to force patients to try and fail on a series of insurer-preferred medications before offering coverage for the originally prescribed option. This is the second time a bill to limit step therapy has been introduced at the national level.
In a conference room overlooking Washington, D.C., nonprofit organizations and other stakeholders gathered around the table and gave U.S. Pain Foundation the opportunity to present ideas and cultivate conversations surrounding patient access issues.
Known as the Keeping Patients Stable on Their Medications Coalition, the group had met in the past to address step therapy and nonmedical switching, two common insurance barriers to medications. Now under the leadership of the U.S. Pain Foundation, the goal is to expand upon the coalition’s initial efforts.
Gov. Branstad Signs HF 233 to Allow a More Transparent Overriding Process
Middletown, CT, May 11, 2017 – Through the efforts of advocates and patient organizations who formed the Iowa Fail First Coalition, of which U.S. Pain Foundation is a member, Iowa Gov. Terry Branstad has signed into law a bill which allows clinicians and patients a clear process to override the fail first protocol, also known as step therapy.
Currently, insurers in Iowa can force a patient to “fail first” on a series of less expensive and potentially inferior medications before receiving the therapy option originally prescribed by their clinician. By turning HF 233 into law, a health insurance carrier must now provide the prescribing health care professional and covered individual access to a clear, accessible and convenient process to request a step therapy override exception.
Governor Cuomo signs S.3419C into Law
Middletown, CT, January 1, 2017– After years of advocating for a transparent and standardized process to appeal step therapy, an insurer protocol which forces patients to fail on a series of medications before receiving the originally prescribed treatment, New York state Governor Andrew Cuomo has signed a bill into law which overrides the unfair insurer practice.
This past year, over 80 patient and provider groups, including U.S. Pain Foundation, banded together to collaborate on initiatives which raised awareness surrounding both step therapy and the proposed legislation by Assemblyman Matthew Titone and Senator Catharine Young. The Assembly and Senate unanimously passed S.3419C, a bipartisan bill designed to create a clear override process for doctors who feel that “failing first” on alternative therapy options could pose negative impacts to their patients.