Fair Health Care VA, a coalition of patient, provider, and healthcare advocacy groups committed to securing access to life-saving treatments for Virginians, today applauded Gov. Ralph Northam for signing House Bill 2126, which improves an insurance requirement known as step therapy or “fail first” protocols. Step therapy protocols, implemented by insurance companies, require a patient to try and fail on one or more older, often less expensive medications before they can receive the treatment originally prescribed by their doctor.
“I am thrilled that Governor Northam has agreed with the General Assembly that all Virginians, especially those with chronic, complex or disabling conditions, deserve a faster and more efficient process to access the care their doctor prescribes,” said Dr. Harry Gewanter, a pediatric rheumatologist in Richmond, Advocacy Chair of the Arthritis Foundation’s Virginia Chapter, and a Fair Health Care VA advocate. “This legislation will ensure that one more barrier to patient-centered, personalized treatment is eliminated in Virginia. We look forward to the effective implementation of this legislation as it will result in reduced frustration by patients, reduced administrative overhead for physicians and reduced costs for the Commonwealth.”
“Patients need timely access to health care, particularly those with chronic and complex conditions. For years, misapplied step therapy has stood as a barrier to that care for patients and their doctors across the Commonwealth,” said Dr. Harry Gewanter, a pediatric rheumatologist in Richmond, Advocacy Chair of the Arthritis Foundation’s Virginia Chapter, and a Fair Health Care VA advocate. “This legislation will help patients receive appropriate therapies when their unique circumstances need personalized treatment and ensure that the patient-physician relationship remains at the center of care decisions.”
In some cases, patients who have already failed on these medications must fail a second, or even third time, before receiving the lifesaving treatment they need. HB 2126, introduced by Delegate Glenn Davis (R-Virginia Beach), improves step therapy by creating an expedited, transparent, and evidence-based system when a patient’s unique situation requires a deviation from step therapy.
“I appreciate Governor Northam signing this critical legislation to protect patients and ensure they have access to effective care, especially for those with chronic, complex conditions,” said Delegate Glenn Davis. “I would also like to thank the House of Delegates and the Senate for supporting this bill and for their commitment to improve the lives of patients across Virginia.”
Last month, the bill passed the Virginia House and Senate with unanimous bipartisan support. Virginia is now the 20th state to take action to improve step therapy.
“I tried and failed three times on the same chemotherapy for my stage four lymphoma before I was finally able to get the life-saving cure that resulted in my first cancer-free scan in 20 years,” said Tom Ema, a patient advocate with the Coalition. “As a patient who has experienced step therapy, I know how important it is for patients to have access to the high-quality care they need, not just the treatment that happens to be cheapest. I’m thankful that step therapy reform has been signed into law and patients will now be able to access the treatment prescribed by their doctor immediately.”
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