Advocacy Win: Step Therapy Bill Passes

Photo: Del. Davis speaking to advocates during the 2019 State Advocacy Day hosted by VBCF & ACS CAN.

Last week, the General Assembly passed legislation will put fair limits on the practice of step therapy.

Step therapy – also known as “fail first” – occurs when a doctor prescribes a medication, but the insurance company requires the patient to try one or several other drugs first, usually based on financial, not medical considerations. For cancer patients, step-therapy can mean an unnecessary delay in access to medication and could cause their health to deteriorate.

The new law will:

  • Ensure that step therapy programs are based on clinical guidelines developed by independent experts;
  • Create an exceptions process for step therapy that is efficient, transparent and accessible to patients and health care providers; and
  • Establish a basic framework for when it is appropriate to exempt patients from step therapy.

This legislation (HB2126) was one of VBCF’s priority issues this year and we are thrilled at its passage!

Thank you to everyone who helped VBCF advocate for this bill over the last few legislative sessions. Delegate Glenn Davis (R-84th) was the sponsor of this legislation and champion of this cause. VBCF is grateful for his leadership.

Other news from the 2019 General Assembly:

  • Short-term health care plans – Several bills passed that expand the length of time that short-term health plans can be used. VBCF opposed this legislation because these plans are not required to cover essential health care services, including cancer screenings. Stay tuned for a future call to action regarding a veto of these bills.
  • Medical cannabis – SB1557 passed which will allow pharmaceutical processors to dispense full therapeutic-strength medical cannabis products. It will also allow nurse practitioners and physician assistants to register as authorized practitioners to certify medical cannabis use for their patients.

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