FOR IMMEDIATE RELEASE
More than 30 Patient & Physician Groups Applaud Georgia Legislation to Reform Step Therapy Insurance Practice
HB 63 Allows Physicians to Override ‘Fail First’ Insurer Decisions in Treatment of Cancer, MS, Diabetes, Psoriasis, Arthritis & Other Chronic Conditions when Medically Necessary;
More than 20 States Have Already Enacted Similar Laws
Atlanta, GA (Jan. 28, 2019) – More than 30 Georgia patient and provider groups led by the Rx in Reach Coalition today applauded Rep. Sharon Cooper (R-Marietta) for introducing House Bill 63 – legislation to reform the insurance practice known as step therapy, which forces patients to try and fail on medications other than what their health care provider prescribes – and in some cases, happens even when patients have already tried the insurer-preferred medications or when those medications could cause their health to deteriorate.
Step therapy, also known as “fail first,” often applies to patients living with life-threatening or debilitating conditions such as cancer, multiple sclerosis, diabetes, arthritis and more. By helping patients get access to what their physician prescribes when it is medically necessary, House Bill 63 improves the step therapy process for patients and physicians, while saving money for the entire health care system.
House Bill 63 only limits step therapy and fail first protocols in certain critical situations, while still allowing insurers to use step therapy when it is appropriate for a patient’s health. The legislation also creates a basic framework for when it is medically appropriate to exempt patients from step therapy protocols and establishes a transparent process for health care providers to request exceptions.
“Physicians know which medicines will work for their patients, and they must be afforded the tools and transparency to obtain exemptions from step therapy when it is medically necessary,” said Rep. Cooper.
“I’m proud to once again introduce legislation to reform step therapy and hope to see Georgia join the more than 20 other states that have already adopted these commonsense protections.”
“Without the passage of House Bill 63, Georgians living with chronic conditions will continue to be kept from the treatments they need to protect their health and remain stable,” said Dorothy Leone-Glasser, RN, HHC, the executive director of Advocates for Responsible Care, which leads the Rx in Reach Coalition. “House Bill 63 introduces much needed transparency and accountability into the step therapy process. As patient advocates, we work cooperatively with legislators to construct legislation that helps reduce medication and treatment costs without compromising health outcomes”.
To read more about Georgians (including a current state legislator) whose health has been negatively impacted by step therapy, visit www.rxinreachga.org/patient-stories.
The Rx in Reach Coalition and supporters of House Bill 63 include: Advocates for Responsible Care, American Association of Diabetes Educators, American Cancer Society, Arthritis Foundation, American Lung Association – Georgia Chapter, American College of Rheumatology, the Atlanta Black Nurses Association, Crohn’s and Colitis Foundation, Georgia AIDS Coalition, Georgia Asthma Coalition, Georgia Bio, Georgia Pain Initiative, Georgia Psychiatric Physicians Association, Georgia Society of Clinical Oncology (GASCO), Georgia Society of Dermatology and Dermatological Surgery, Georgia Society of Ophthalmology, Georgia State Medical Association, Georgians for a Healthy Future, Hemophilia of Georgia, Infectious Disease Society of Georgia, LACES, Lung Cancer Alliance, Lupus Foundation of America – Georgia Chapter, Medical Association of Georgia, Mental Health America, Metro Atlanta Rheumatology Society, NAMI Georgia, National Eczema Association, National Multiple Sclerosis Society, National Patient Advocate Foundation, National Psoriasis Foundation, TRAGIC and U.S. Pain Foundation.
About Rx In Reach
The Rx in Reach GA Coalition – a project of Advocates for Responsible Care– is a partnership of more than 30 other health-centered organizations advocating for legislation that ends the financial and discriminatory barriers to securing vital medications. For more information, visit www.RxinReachGA.org.