Step therapy protocols; disclosures. (HB1755)

Introduced By

Del. Glenn Davis (R-Virginia Beach) with support from co-patron Del. Patrick Hope (D-Arlington)

Progress

Introduced
Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law

Description

Step therapy protocols; disclosures. Requires health insurers that limit coverage for prescription drugs through the use of a step therapy protocol to have in place a process for a prescribing provider to request an override of the protocol for a patient. A step therapy protocol is a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition are medically appropriate for a particular patient and are covered by a health benefit plan or that conditions coverage of a prescription medication on a patient first trying an alternative medication without success. The measure requires the granting of a step therapy protocol override in certain circumstances. Finally, the measure requires an insurer that offers a health benefit plan that uses a step therapy protocol to provide (i) written notice of a determination that the protocol requires denial of coverage of a provider's selected prescription drug, (ii) an explanation of the basis for such determination, and (iii) notice of the procedures for submitting a request for an override of the restrictions of the step therapy protocol. Read the Bill »

Outcome

Bill Has Failed

History

DateAction
01/08/2017Committee
01/08/2017Prefiled and ordered printed; offered 01/11/17 17101997D
01/08/2017Referred to Committee on Commerce and Labor
01/12/2017Assigned C & L sub: Subcommittee #2
01/20/2017Impact statement from SCC (HB1755)
01/24/2017Subcommittee failed to recommend reporting (4-Y 6-N)
02/08/2017Left in Commerce and Labor

Duplicate Bills

The following bills are identical to this one: HB362.

Comments

Deborah Grotenhuis writes:

Too bad. Now you will try three drugs and see your provider three times before you (possibly) finally get the drug that will work. Who is saving time and money with this law? Come meet my patients with Interstitial Cystitis and the others with low testosterone and watch what they, our clinic providers and we the nurses go through stepping people along. This is a bogus process.