Senate Bill (SB) 243 was heard by the Senate Medicaid Committee on December 7. Ohio Academy of Family Physicians Past President Sarah Sams, MD, testified before the committee in support of SB 243, a proposal to reform step therapy processes used by insurance companies that have become huge barriers to patient care.
The OAFP strongly supports SB 243 and urged its passage prior to the end of the lame duck session. That, however, did not happen. The bill will be re-introduced for consideration by the next General Assembly.
Step therapy is a one-size-fits-all policy and for many physicians and patients it has become a barrier to getting the right care at the right time. Step therapy can undermine physicians’ ability to effectively treat patients, lower quality of care, and lead to set backs and disease progression for patients.
SB 243 does not prohibit insurers from using step therapy but seeks to balance cost containment with patient needs. SB 243 protects patients by ensuring that step therapy programs are based on clinical guidelines developed by independent experts and that the exceptions process for step therapy is transparent and accessible to patients and their physicians.
Eleven other states have enacted legislation similar to SB 243.