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Rheumatology Groups Call for New York Governor to Sign ‘Step Therapy’ Legislation into Law
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New York Governor Andrew Cuomo is being urged by some rheumatology groups, including the American College of Rheumatology and the Arthritis Foundation, to sign into law legislation that would curb “step therapy” and “fail-first” policies by health insurers in the state, according to a press release.
Under “step therapy” or “fail-first” policies, patients are required to try and fail one or more lower cost drugs or services before an insurer will cover a more expensive drug or service prescribed by physicians. The bipartisan step therapy bills S.03419-C and A.2834-D were unanimously passed in the New York legislature. Governor Cuomo has until the middle of July to review the legislation.
If enacted, the legislation would establish an abbreviated process for prescribers to override step therapy protocols in cases of medical necessity, the release from the American College of Rheumatology (ACR) noted. The amount of time a patient is required to try and fail different medications from the one prescribed by his or her doctor would also be limited by the legislation.
“Step therapy policies create unnecessary obstacles for patients, delay clinically appropriate treatments, undermine the decisions made between patients and physicians, and lead to unnecessary and avoidable health care costs,” Howard Blumstein, MD, chair of the ACR Affiliate Society Council and the New York State Rheumatology Society Government & Payor Relations Committee, said in the release. “For many patients living with rheumatic and autoimmune diseases, step therapy practices can also create potentially life-threatening outcomes.”
According to the release, New York follows other states, such as Illinois, Indiana, Missouri and West Virginia, that have passed similar legislation this year.
References:
www.nysenate.gov/legislation/bills/2015/a2834/amendment/d
www.nysenate.gov/legislation/bills/2015/S3419