Legislation is pending in Congress that will help patients access medications prescribed by their physician.

The Safe Step Act (S. 2903 / H.R. 5509) creates a clear, timely and transparent process for a patient or physician to request an exception to step therapy protocols in certain situations. Step therapy is a health insurance protocol that requires patients to first  fail on one or more medications before coverage for the treatment initially selected by the patient and their health care provider will be approved.

The legislation requires that group health plans must grant an exception to “fail-first” protocols in certain situations, including if a request for an exception clearly demonstrates the:

• patient already tried and failed on the required drug;
• required drug will cause harm to the patient;
• required drug will prevent a patient from working or fulfilling daily activities; or
• patient is stable on his/her current medication.

The bill also requires that a request for an exception to step therapy be answered by the insurance company within three days, and in less than 24 hours for urgent situations. 

Contact your members of Congress and ask them to support the Safe Step Act. You can send an email message quickly and easily through ACOI’s new grassroots advocacy platform. ACOI has created a template letter that you can choose to personalize and share why passage of the Safe Step Act is important to you and your patients. 

Take action today!