Virginia General Assembly passes step therapy reform

Fair Health Care Virginia CoalitionFair Health Care VA today applauded the General Assembly for passing House Bill 2126, which improves patient access to healthcare by reforming health insurance step therapy or “fail first” protocols.

The bill, which passed the House and Senate with unanimous bipartisan support, now goes to Gov. Ralph Northam for signature. Virginia is now the 20th state in the nation to pass step therapy reform legislation.

“All Virginians applaud the Virginia General Assembly for unanimously passing Del. Glenn Davis’ step therapy improvement bill, HB 2126. Patients and physicians throughout the Commonwealth will now have fewer barriers to appropriate therapies when the patient’s unique circumstances need personalized treatment,” 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. “We look forward to Gov. Northam quickly signing this bill into law to ensure that the patient-physician relationship remains at the center of care decisions.”

Step therapy protocols, implemented by insurance companies, traditionally require a patient to try, and fail, on one or more medications before they can begin the treatment plan originally prescribed by their doctor. 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 – all because they switched insurance providers.

HB 2126, introduced by Del. Davis (R-Virginia Beach), improves step therapy protocols by creating an expedited, transparent, and evidence-based system when a patient’s unique situation requires a deviation from step therapy.

“I applaud the House of Delegates and the Senate for supporting this critical legislation to help patients across Virginia who have their own stories about step therapy, including being denied effective care for their chronic, complex conditions,” said Del. Davis. “I urge Gov. Northam to sign HB 2126 to help improve this process for patients across the state.”

“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,” said Tom Ema, a patient advocate with the Coalition. “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. I’m heartened that step therapy reform has passed the General Assembly and patients will now be able to access the treatment prescribed by their doctor immediately.”

About Fair Health Care VA

Fair Health Care VA is a coalition of more than a dozen patient, provider, and health care groups committed to making sure Virginians living with chronic health conditions have access to the life-saving treatments they need. Fair Health Care VA works to raise awareness and educate patients about their rights when it comes to accessing their medications. The coalition supports policies that protect patient access to the treatments they need.



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