It's Time for a Fight: Patients against Step Therapy!
- Establishes circumstances for the prescribing health care provider to override step therapy when medically appropriate for a patient.
- Ensures step therapy protocols are based on clinical guidelines and not solely cost to the health plan.
- Provides for a transparent exception and appeals process for prescribing health care providers and their patients.
- Limits the review process for the appeals to 72 hours for non-emergency and 24 hours for emergency cases.