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Step therapy bill heads to Evers

06/19/2019 10:02 PM | Jamie Michael (Administrator)

*From Wisconsin Health News, June 19

The Assembly signed off on a bill Tuesday that would allow patients to bypass health plan policies that require them to try cheaper medications before more expensive ones.

The bipartisan proposal, which passed the Senate earlier month, now heads to Gov. Tony Evers’ desk.

The approval comes after lawmakers consulted with insurers and other healthcare providers and amended the legislation. Under the proposal, insurers, pharmacy benefit managers and utilization review organizations have to allow patients to apply for exceptions to step therapy protocols.

The companies would have to grant their requests if providers submit supporting documentation under certain conditions, like if the cheaper drug could cause serious side effects, is expected to be ineffective or the patient has tried the drug before.

“We arrived at a bill that keeps the spirit, integrity, and patient protections of the original bill, while still ensuring the health plans have the ability to meaningfully utilize step therapy protocols in order to keep costs down,” bill author Rep. John Nygren, R-Marinette, said in a statement.

The chamber also signed off on a bill that would change state law so distributors of products necessary for home dialysis don’t need to be licensed as pharmacies. That bill also heads to Evers.

And it passed legislation allowing properly trained pharmacists to administer vaccines prescribed to children under the age of 6. The Senate has yet to take up the measure.


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