Article by: Dr. Chris Philli
I am completing my 3rd year as chair of the Insurance Subcommittee for the American College of Rheumatology. Advocacy work is important to me because it’s how I give back to others through my work but also how I can impact the lives of my patients and the arthritis community on a greater level.
Last month, I attended a virtual “Hill” day where we had Zoom calls with our congressional teams. During this call, I advocated for the bipartisan Safe Step Act (S. 464) regarding step therapy.
Step therapy is when insurance plans remove the ability to prescribe the most appropriate treatment from physicians, without first forcing patients to try the therapies preferred by the insurance companies. This unfair method used by insurance companies can have severe consequences for patients.
Step therapy does not work. But did you know that 47% of rheumatic disease patients have been subjected to it? (view the entire survey here).
It’s frustrating for both health care providers, like myself, and patients.
That’s why I am joining my colleagues who serve alongside me on the board of the American College of Rheumatology and thousands of rheumatologists across the country to advocate against step therapy.
Congress is joining our efforts and playing a part to reduce and/or remove step therapy from insurance plans through the bipartisan Safe Step Act (S. 464).
If this act is approved, it will place reasonable limits on insurance companies’ use of step therapy and create a clear and transparent process for patients and physicians to seek exceptions from it.
The legislation outlines 5 situations in which a patient could bypass step therapy:
1) if he or she has already tried and failed the insurer-preferred drug
2) if delayed treatment will cause irreversible consequences
3) if requiring the insurer-preferred drug will cause harm to the patient
4) if the required drug will prevent a patient from working or fulfilling activities such as eating, grooming, dressing, bathing
5) if the patient is stable on the prescription drug selected by their provider and that drug has been covered by their previous insurance plan.
(source: The Hill)
Will you join me in advocating for the bipartisan Safe Step Act (S. 464)?
Here’s how: Reach out to your congressional representative, tell your story and let them know WHY you want to see the Safe Step Act approved.