Safe Step Act

Key Points

• This bill targets 'step therapy,' a practice where insurance companies make patients try cheaper drugs that might not work before they will pay for the medicine a doctor originally prescribed.
• Health plans would be required to create a clear and fast way for patients or doctors to ask for an exception if the insurance company's preferred drug is dangerous, ineffective, or would cause the patient's condition to get worse.
• Insurance companies would have to make a decision quickly: within 72 hours for regular requests and within 24 hours if a patient’s life or health is in immediate danger.
• Exceptions must be granted if a patient is already stable on their current medicine or if the insurance company's required drug would prevent them from working or taking care of themselves.
• If an exception is approved, the insurance company must continue to cover that specific drug for at least one year to ensure the patient's treatment is not interrupted.