Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Step Therapy topic
No spam. Unsubscribe anytime.
Committee moves to recommend ‘do not pass’ on step‑therapy expansion after questions about need and definition
Summary
Senate Bill 2248, which would add ‘associated conditions’ to the state’s restrictions on step therapy, received skepticism from committee members about implementation and necessity; the committee voted to recommend a do‑not‑pass on the bill.
The committee reviewed Senate Bill 2248, a proposal to expand restrictions on step therapy protocols by adding the phrase “associated conditions” for metastatic cancer and other diagnoses. After extended discussion about implementation challenges and whether the law already prohibits problematic step therapy, the committee voted to recommend “do not pass.”
Why it matters: Step therapy rules affect how insurers require patients to try lower‑cost treatments before approving others. Committee members said existing state law (Century Code chapter referenced in the hearing) already prohibits step therapy in certain situations and that many major carriers already do not require step therapy for the affected conditions. Members expressed concern that “associated conditions” is undefined and could be difficult to implement or could be used cosmetically to say a mandate exists without a demonstrated need.
Key discussion points: A witness referenced Century Code chapter 19‑02.116.03 as already prohibiting step therapy for metastatic cancer; committee members said that adding “associated conditions” without a clear definition could create ambiguity (for example, whether nausea related to cancer qualifies while pre‑existing migraines would not). Committee members discussed that a majority of residents are covered by employer (ERISA) plans, which state mandates cannot regulate, and that a large share of plans already lack step therapy in practice.
Vote and outcome: Senator Hogan moved “do not pass,” seconded by Senator Weston; the committee recorded a 6-0 vote for do‑not‑pass. The committee discussed pursuing a narrower approach or a study if stakeholders present additional implementation details.
Ending: Members suggested that, absent a clearly defined problem or carrier practices demonstrating the need, the committee was not prepared to expand statutory prohibitions. The motion to recommend do‑not‑pass will be reflected in committee reporting to the next stage.
