Lemiska meeting with a sponsor of the Reliable Coverage Act in Tennessee.

Non-medical switching, or when insurers force patients off medications for financial reasons, continues to be a hot button topic in numerous states. U.S. Pain is leading coalitions in three states that introduced bills to prohibit non-medical switching last month: Tennessee, Illinois, and Connecticut. U.S. Pain is a member of coalitions in multiple other states, including New Jersey, New York, Pennsylvania, Florida, and Washington.

State advocacy staff are keeping busy educating the public about the negative effects of non-medical switching. Shaina Smith, director of state advocacy and alliance development, was one of three featured speakers at a roundtable discussion about non-medical switching in Albany, N.Y, on Feb. 21.  In addition, Emily Lemiska, assistant director of state advocacy, was quoted in a Feb. 2 article about non-medical switching, “New Rules Aim to Keep Patients on Medications That Work” published by Pew Trusts and later in the Huffington Post.

You can help the U.S. Pain team in its fight against non-medical switching by taking this survey. The survey is open to both patients (with any health condition, including chronic pain) and clinicians.

Details about non-medical switching bills U.S. Pain is currently supporting can be found below:

State Name Bill number Bill status
Colorado A bill for an act concerning the prohibition against a carrier requiring a covered person to undergo step therapy, and, in connection therewith, requiring coverage for a prescribed medication that is part of the carrier’s medication formulary. SB17-203  

Senate committee held a hearing, but the bill did not pass.


Connecticut An act limiting changes to health insurers’ prescription drug formularies




HB 7123


Public Hearing 03/02 in Joint Committee on Insurance and Real Estate

Florida An act relating to consumer protection from nonmedical changes to prescription drug formularies


SB 182/HB95


Senate: Now in Appropriations
House: 2/22/2017 CS by Health Innovation Subcommittee
Illinois Amendment to the Managed Care Reform and Patient Rights Act


HB 2694


Assigned to Human Services Committee


Maryland An act concerning: Health Insurance – Prescription Drugs – Formulary Changes


HB 1128 / SB 768


Senate: The Senate version is scheduled to be heard before the Finance Committee on 3/8/17.


New Jersey An act concerning prescription drug coverage for certain medical conditions and supplementing various parts of the statutory law


S. 2969/A. 4205


Senate: Introduced in the Senate, Referred to Senate Commerce Committee

Assembly: Introduced, Referred to Assembly Financial Institutions and Insurance Committee


New Mexico An act … to establish limitations on health cover and provider contract changes. HB 112


Reported by Health and Human Services Committee with Do Not Pass, but without recommendation on Committee Substitution


New York An act to amend the insurance law, in relation to prescription drug formulary changes during a contract year A. 2317


Referred to Insurance Committee


Oregon A bill for an act relating to insurance coverage of prescription drugs; creating new provisions; and amending ORS 743B.013, 743B.105 and 743B.125. SB 232


Hearing in the Senate Committee on Health Care


Tennessee An act to amend Tennessee Code Annotated, Title 56, relative to limiting changes to commercial health insurers’ prescription drug formularies during the health plan year.


HB 960/SB 991 House: Assigned to s/c Insurance and Banking Subcommittee

Senate: Passed on Second Consideration, refer to Senate Commerce and Labor Committee

Washington An act relating to prescription drug insurance continuity of care; and adding a new section to chapter 48.43 RCW.


SB 5160/HB 1211


Senate: Public hearing in the Senate Committee on Health Care

House: Referred to Health Care & Wellness

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