Tag Archives: step therapy

VA Gov. Northam Signs Step Therapy Reform Bill Into Law

On Tuesday, March 12, Virginia joined the ranks of 22 states that have passed legislation to curb step therapy. House Bill 2126, which was signed into law by Virginia Gov. Ralph Northam, reforms step therapy, or “fail first,” insurance protocols that force patients to try and fail an insurer-preferred medication before the medication their doctor originally prescribed. This legislation places important guardrails to protect patients from the inappropriate use of burdensome step therapy protocols.

Patients and providers have been working hand in hand on reforming step therapy protocols in Virginia since 2016. Countless touchpoints with legislators have gotten us across the finish line, including letters sent to legislators, op-eds published in local newspapers, coalition-based initiatives through Fair Health Care VA and even state legislative days with in-person legislator meetings in Richmond.

Dr. Harry Gewanter, Arthritis Foundation Ambassador and chair of the Virginia advocacy committee, played an instrumental role in the success of this bill. Of the step therapy win, Dr. Gewanter says: “This legislation will help patients receive appropriate therapies when their unique circumstances need personalized treatment and ensure that the patient-physician relationship remains at the center of care decisions.”

The Arthritis Foundation thanks all legislators who have supported the bill, specifically Delegate Davis, who has championed this bill for four years. You can share your gratitude with the legislature as well!

If you have a step therapy story, we want to hear from you. 

You can learn more about advocacy and amplifying your voice by becoming an Arthritis Foundation Advocate! Sign up today!

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Step therapy, also known as “fail first,” is a tool used by insurers that requires patients to try a less expensive treatment, or series of treatments, before they can access the drug originally prescribed by their physician. Overly burdensome step therapy requirements can jeopardize the patient-provider relationship and unnecessarily prolong ineffective treatment, preventing patients from immediately starting, or in some cases continuing, to access the most appropriate treatment recommended by their doctor. Continue reading Importance of Step Therapy Reform

Medicare Advantage

Considering a Medicare Advantage plan for 2019?

An important change is coming that you should know about!

The administration recently released guidance that allows Medicare Advantage (MA) plans to use step therapy. This is new for next year and a few health insurers have already said they will institute the policy. In this week’s Take Care blog, we break down the issue to help you make the best choice during open enrollment season. Remember: Medicare open enrollment has already started and continues through December 7. Read on to get the scoop on this change to Medicare Advantage plans.

Continue reading TAKE CARE: Advocacy Blog Series Medicare Advantage Plan Change Coming in 2019

100 advocacy state victories

The Arthritis Foundation reached a milestone in September, securing our 100th state legislative victory since 2014! Congratulations Advocates!! All of these victories were made possible due to all of you!

Our victories occurred in 47 states plus Washington, DC, impacting more than 50 million people with doctor-diagnosed arthritis, and have focused on many patient access to care issues like:

Continue reading 100 State Advocacy Victories….and Counting!

minnesota step therapy advocacy

On May 19, Minnesota Gov. Mark Dayton signed HB 3196 into law! Step therapy legislation gives physicians a clear path toward getting their patients the medications they need.

Having access to affordable, effective and specialized medication is critical for the 54 million Americans living with doctor-diagnosed arthritis nationwide, including over 900,000 in Minnesota. The Arthritis Foundation thanks the bill’s sponsors and Gov. Dayton for helping provide these patient protections to Minnesotans.

Step Therapy is a practice used by insurers that requires people with arthritis to try lower-cost medications before allowing more expensive treatments, despite a physician’s recommendation.

Continue reading MN Governor Dayton Signs Legislation for Step Therapy Guardrails

shanna new mexico legislation

On Wednesday, February 28th, New Mexico joined 17 other states across the country in passing legislation to curb step therapy. Senate Bill 11, which was signed into law by New Mexico Governor Susana Martinez, reforms the process that forces patients to try drugs that insurance companies choose, making patients “fail first” before the patient gets to use the medicine that their doctor originally prescribed.

Step therapy is an insurance practice that requires patients to use a lower-cost drug before permitting more expensive drugs – regardless of what your doctor prescribed. This may occur even if you are already taking that pricier medication and doing well on it.  Senate Bill 11 placed limits on this practice and helps get the right medicine to patients faster.

Continue reading NM Governor Martinez Signs Senate Bill 11 into Law to Curb Step Therapy

amy barron platinum arthritis ambassador

ADVOCACY COMMITTEE REACHES GOAL!

 By Amy Barron, Platinum Ambassador, OH Advocacy Committee

I am privileged to serve as a member of the Arthritis Foundation’s Ohio State Advocacy Committee. Advocacy committees like mine help to chart the course of local and state-wide advocacy action for our arthritis community. Many of our committee members serve as Arthritis Foundation Advocates and Ambassadors, at both the state and federal level.

Continue reading Platinum Ambassador Spotlight: Amy Barron, OHIO

rebecca gillett

In 2016, I was fortunate to attend the Arthritis Foundation Advocacy Summit in Washington D.C. alongside some seasoned advocacy veterans from Denver. I had never met with my legislators or shared my story before, so it was a new experience. It was easy to “catch the bug” for advocacy being surrounded by so many other fellow arthritis patient advocates who want to make a difference for all of us. Raising awareness and fundraising for arthritis has been an integral part of my life for the past several years, but advocacy has become an even greater passion. This year, I achieved the Platinum Ambassador Award and will attend the Arthritis Foundation’s Platinum Ambassador Assembly this March 12-13, 2018.

Continue reading Platinum Ambassador Spotlight—Rebecca Gillett, Colorado

lori fagan arthritis ambassador spotlight

From Lori Fagan

I have been living with rheumatoid arthritis (RA) for over a decade. As a full-time working mom and wife living with a chronic condition, the last thing I need is the added strain of fighting with my health insurer.

Unfortunately, because of a common health insurance practice known as “step therapy,” the last 10 years have been a constant and stressful battle.

Continue reading Ambassador Spotlight – Lori Fagan, Virginia

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