- Currently in Effect
- Legislation Introduced
What is a target State?
The NPF and our coalition partners take a thoughtful approach each year to determine target states. These are states that the NPF has an active engagement and leadership role regarding step therapy legislation, and are states that contain some or all of our supported legislation model language. Contact us for more information and to find out how you can advocate in your state!
What is the solution?
The NPF policy team has worked in collaboration with other patient and provider groups to craft model legislation that impacts all people with a chronic disease – all of whom are negatively affected by step therapy. The NPF supports the passage of that model legislation, which ensures step therapy is based on the most current clinical data and that it is available to the consumer in a transparent manner. Furthermore, it provides a timeline for response to requests that is based on language agreed upon in other states. Finally, it outlines clear and concise exceptions to the step therapy protocols based on medical necessity. This legislation, which is not a ban and does not lead to additional costs, strikes a fair balance between cost containment and health of the patient.
U.S. Congress is taking action as well!
Our success at the state level has led to a Federal effort focused on amending the Employee Retirement Income Security Act (ERISA) to require a group health plan provide an exception process for any medication step therapy protocol. Authored by Representatives Raul Ruize and Brad Wenstrup, the Safe Step Act was first introduced in 2017 with a Senate companion bill on 2019. In 2021, the Safe Step Act was re-introduced in the House and Senate: H.R. 2163 & S. 464 aim to enact a review process that ensures step therapy protocols are based on sound clinical guidelines, a clear and convenient step therapy exception process, and establishes a timeline that health insurers must meet when receiving an exception request.
Ask your member of Congress to support the Safe Step Act by sending them a message.