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.
“Step therapy can result in increased symptoms, side effects, and even relapse for the children and adults we serve,” says Shaina Smith, Director of State Advocacy and Alliance Development for U.S. Pain. “We support HR 2279 because we believe that treatment decisions should be kept in the hands of clinicians and patients, and that these decisions should be made based on the patient’s best interest, not the insurer’s.”
Smith notes that the federal bill would not completely end step therapy protocols, but would require that health plans respond to override requests in a timely manner, decreasing the amount of time families and individuals wait to receive their medically appropriate and necessary medicine; clinicians would also have a more easily accessible process to request that their patient not be subjected to step therapy due to specific circumstances.
At the state level, U.S. Pain Foundation has been working for many years to combat step therapy or “‘fail first” practices. This legislative session, a handful of states have enacted step therapy reform, including Virginia, Georgia and Oklahoma; Washington state will have its step therapy bill, HB 1879, signed by the Governor on April 6. A total of 23 states have passed step therapy protections, with several states considering bills currently.
To get involved with U.S. Pain Foundation’s advocacy efforts, click here.