Rx in Reach Georgia
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Dorothy Leone-Glasser, RN, HHC
Executive Director,

Advocates for Responsible Care

Email: dlg@arxc.org
Phone: 404-633-5843

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Georgia House of Representatives Passes 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 (Feb. 15, 2019) – More than 30 Georgia patient and provider groups led by the Rx in Reach Coalition today applauded the state House of Representatives for passing House Bill 63 – legislation sponsored by Rep. Sharon Cooper (R-Marietta) 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. In some cases, insurers even require step therapy when patients have already tried the insurer-preferred medications, or when those medications could cause their health to deteriorate. 

 

House Bill 63 will now move to the Georgia State Senate for consideration.

 

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 aiming to save 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.

 

“Georgia is one step closer to finally reforming step therapy as more than 20 other states have already done,” said Dorothy Leone-Glasser, RN, HHC, the executive director of Advocates for Responsible Care, which leads the Rx in Reach Coalition. “Step therapy is hurting people across Georgia by causing unnecessary health complications. By empowering health care providers by introducing much-needed transparency and accountability into the step therapy process, House Bill 63 makes step therapy work better for patients and insurers alike.”

  

To read more about Georgians whose health has been negatively impacted by step therapy, visit www.rxinreachga.org/patient-stories.

 

The Rx in Reach Coalition includes: Advocates for Responsible Care, American Association of Diabetes Educators, American Cancer Society, American College of Rheumatology, Arthritis Foundation, Atlanta Black Nurses Association, Crohn’s and Colitis Foundation, Georgia Academy of Family Physicians, 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.

 

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