04/07/2021

Senate Bill Seeks to Limit Use of Step Therapy in Employer Health Plans

The bipartisan bill spells out 5 step therapy exemptions for patients by amending the Employee Retirement Income Security Act of 1974. 

Bipartisan legislation introduced earlier this month in the Senate would create 5 situations where a patient would be exempted from step therapy in employer-sponsored health plans, sometimes assailed as “fail first” policies by patients and providers.

Step therapy, along with prior authorization and formulary lists, are some of the tools used by payers in an effort to control skyrocketing drug costs. Patient groups and providers counter that they can delay care prescribed by a physician.  READ MORE