Download this proposal as a PDF.

Commenting for this proposal will be open until the close of business on Monday, June 5.

Title of Proposal:

Re-visit step therapy

On behalf of:       

Dr. Mitchell Miller and Dr. Sterling Ransone

Describe the Idea or Issue:

Step Therapy reform in essence is a follow-up to Prior Authorization reform, which MSV supported a few years ago. Step Therapy reform was supported by MSV this past GA session.

This issue remains a thorn in the side of every patient and every prescribing physician. There are countless examples of how being forced, by insurers, to use a medication which has either failed in the past, or for some other reason is inappropriate, especially if a patient is successfully managed on a medication that is not "first step" per the insurer, can ultimately harm the patient or at minimum severely inconvenience him or her.

The massive hassle factor for physicians and their staffs is another reason for seeking reforms.

Desired Outcome:

Significant reforms which are both patient and physician friendly, and yet recognize the economic challenges of providing appropriate treatments for patients.

Background/Supporting Information:

This is basically a follow-up on the same issues as this past year.

West Virginia recently passed legislation on this issue.

We need to keep up the pressure on this issue.

Several patient advocacy groups are in full support and are natural allies.

Above all, this is an issue which helps patients immensely, and it simultaneously helps ALL practicing physicians.

Additional background materials in appendix.

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