Ask Congress to Ensure Timely Access to Medications

Pending in the U.S. Senate and House of Representatives is bipartisan legislation that will improve patient access to their prescribed treatments.

The Safe Step Act (S. 652 / H.R. 2630) creates a clear, timely and transparent process for a patient or physician to request an exception to step therapy protocols in certain situations. Step therapy is a tactic used by insurance companies that requires a patient to try and fail one or more medications before approving coverage of the treatment prescribed by their health care provider.

The legislation requires that group health plans must grant an exception to “fail first” protocols in certain situations, including if an application clearly demonstrates:

Patient already tried and failed on the required drug
Required drug will cause harm to the patient
Required drug will prevent a patient from working or fulfilling daily activities
Patient is stable on his/her current medication

The bill also requires that a request for an exception to step therapy be answered by the insurance company within three days, and in less than 24 hours for urgent situations.

The Senate is expected to consider legislation the week of July 10 that requires more transparency from pharmacy benefit management (PBM) companies. This bill includes the Safe Step Act. Contact your senators this week and ask them to support the Safe Step Act. You can send an email message quickly and easily through ABC’s grassroots advocacy platform. A template letter is available that you can choose to personalize and share why passage of the Safe Step Act is important to you.

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