Cassidy introduces bipartisan bill creating exceptions process for medication step therapy

U.S. Sen. Bill Cassidy (R-LA) is cosponsoring a bipartisan bill that would require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol.

Such protocols are used by health plans to control spending on patient’s medications and to ensure patients may safely and efficiently access treatment. In some instances, step therapy protocols may ignore a patient’s unique situation and medical history, resulting in negative impacts, including delayed access to effective treatment, severe side effects and irreversible disease progression, according to a statement from Sen. Cassidy’s office.

“Doctors and patients should not have to work through multiple medicines, which have already failed or which may cause more harm than good,” Sen. Cassidy said. “This bill allows the proven right medicine to be given as soon as possible.”

Sen. Cassidy on Sept. 25 introduced the Safe Step Act of 2019, S. 2546, with bill sponsor U.S. Sen. Lisa Murkowski (R-AK) and six other cosponsors, including U.S. Sen. Doug Jones (D-AL) to establish a clear and transparent exemption process to a step therapy protocol.

The bill outlines five exceptions to such protocols and would require that a group health plan grant an exemption if an application clearly demonstrates that: a patient tried and failed on the required drug; delayed treatment will cause irreversible consequences; the required drug will cause harm to the patient; the required drug will prevent a patient from fulfilling daily living activities; and a patient is stable on his or her current medication.

The measure has been referred to the U.S. Senate Health, Education, Labor, and Pensions Committee for consideration.