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Governor Evers signs Step Therapy Law

JANESVILLE (WKOW)– It is now easier for doctors and patients to make decisions about medications without health insurance companies denying their requests.

Gov. Tony Evers signed the bipartisan Step Therapy legislation into law today. Step therapy, which is also called “fail first” therapy, is the process that health insurance companies require before authorizing more expensive and possibly more effective medication.

People with chronic and complex conditions often struggle the “fail first” process when the more expensive and effective medications their physicians are recommending are denied by insurance carriers.The insurance company usually wants them to try the cheaper brands first.

The new law doesn’t eliminate step therapy, it sets new guidelines and gives more decision power to the physicians and patients instead of the insurance companies. It makes it harder for the insurance companies to deny authorization for the much needed medications.

“State leaders joined together in unanimous passage of this measure which has now become law and clearly puts patient concerns first, not last. The governor and legislators agreed that making patients try and fail on multiple medications first before receiving what their doctor ordered was not only a bad insurer policy, but it removed the patient and doctor from the health decision,” said Angie Thies, the leader of the Wisconsin Step Therapy Coalition in a news release.

“Now, this law puts strong protections in place to ensure the patient and doctor’s voice comes first and patients are getting the access to medications they need,” said Thies.

The law also makes it easier for dialysis patients to receive dialysis at home by removing protocols that required only certain dialysis medication distributors to give out medications. Now, dialysis patients can have the medications and supplies delivered to their home. The law also allows the patients to receive training on how to administer their dialysis medications and use the dialysis equipment.

“I have always said that healthcare should not be a privilege afforded to only the healthy and the wealthy. We have to do everything we can to ensure that everyone can access to the lifesaving care their need and deserve without barrier or burden,” said Evers.

Megan Zemple

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