Current Step Therapy Legislation
WHAT IS STEP THERAPY?
Step Therapy, also known as “Fail-First” policy, is used by health insurance plans as a way to control costs. This cost-management strategy requires patients to try and document failure for one or more “preferred” treatment options before pursuing another treatment option. Many times, these fail-first requirements are not part of the medications FDA labeling and are added into the prior-authorization process by health plans based on their own internal research or financial analysis.
Below are federal and state level step therapy bills that NICA currently supports or opposes. Click on a colored state to learn more.