   
alabama
BILL # No known legislation existing or recently introduced.
alaska
BILL # No known legislation existing or recently introduced.
arizona
BILL # No known legislation existing or recently introduced.
arkansas
BILL # No known legislation existing or recently introduced.
california
BILL # AB369
DATE INT. 2/14/11
SPONS. Assemblymember Jared Huffman (D), Assemblymember Jim Beall (D), Assemblymember Mike Feuer (D), Senator Fran Pavley (D)
STAGE Assembly Appropriations Committee postponed hearing on bill in May 2011. Still being held there.
STATUS STALLED
PURPOSE This bill would limit a health plan's or health insurer's ability to use to step therapy or "fail first" protocols for the treatment of pain. The bill would require that the duration of any step therapy or fail first protocol be determined by the prescribing physician and would prohibit a health plan or health insurer from requiring that a patient try and fail on more than two pain medications before allowing the patient access to other pain medication prescribed by the physician. This bill would still allows step therapy to be used, but closes loopholes and puts the medical decisions back in the doctor's hands so the patient can get the right medication in a timely fashion.
colorado
BILL # No known legislation existing or recently introduced.
connecticut
BILL # SB1083
DATE INT. 2/24/11
SPONS. Sen. Edith G. Prague (D), Sen. Kevin D. Witkos (R), Sen. Joseph J. Crisco (D), Sen. Steve Cassano (D), Sen. Edwin A. Gomes (D), Sen. Gayle S. Slossberg (D), Rep. Bruce Zalaski (D), Rep. Patricia M. Widlitz (D), Rep. Gregory Haddad (D)
STAGE Effective 1/1/12
STATUS ACTIVE
PURPOSE To prohibit individual and group health insurance policies that provide coverage for prescription drugs from requiring insureds to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.
NOTE: Bill specific to pain medication only. delaware
STATUS ACTIVE
PURPOSE Since 7/1/03, Delaware has aggressively promoted step therapy practices to cut costs. However, physicians can prevail in most instances with prior authorization prescriptions.
florida
STATUS ACTIVE
PURPOSE SB792 from 2001 requires that the Medicaid program develop a "preferred drug formulary" or list for all categories of drugs. Drugs not on that list will be subject to prior authorization before being dispensed.
NOTE: Does not appear to apply to non-Medicaid patients. Such legislation has not yet been found. georgia
BILL # No known legislation existing or recently introduced.
hawaii
BILL # HB664
DATE INT. 1/24/11
SPONS. Rep. Cindy Evans (D)
STAGE Referred to committee. No date was set to bring vote to House floor.
STATUS STALLED
PURPOSE Prohibits pharmacists, health insurers, mutual benefit societies, and health maintenance organizations from substituting medications prescribed to post-operative transplant patients when a prescribing physician indicates "do not substitute."
NOTE: Bill specific to immunosuppressant medication only. idaho
BILL # HB260
STAGE Provision addressed step therapy-related copayments for Medicaid patients, but was axed from final bill.
STATUS DEAD
PURPOSE Cuts to Medicaid. This provision: nonpreferred prescription drugs. A nonpreferred drug is a drug for which an alternative therapeutically interchangeable drug in the same pharmacological class is available whose use provides advantages to the medicaid program based on relative safety, effectiveness, clinical outcomes and cost. Pharmacy providers may be required to collect copayments at the point of service. Pharmacy providers shall not be required to dispense any prescribed medication unless a medicaid participant provides for any applicable copayment under this paragraph. Copayments shall not constitute a reduction of overall reimbursement to pharmacists for the dispensing of prescribed medicine.
NOTE: Applied only to Medicaid patients. illinois
BILL # SB1415
DATE INT. 4/10/09
SPONS. Sen. James F. Clayborne, Jr. (D), Sen. M. Maggie Crotty (D), Sen. Michael Noland (D), Sen. Mike Jacobs (D), Sen. John J. Millner (R), Sen. Don Harmon (D), Sen. Mattie Hunter (D), Sen. Heather Steans (D), Sen. Ira I. Silverstein (D), Sen. Iris Y. Martinez (D), Sen. Donne E. Trotter (D), Sen. Jacqueline Y. Collins (D), Rep. Gary Hannig (D), Rep. Sara Feigenholtz (D), Rep. Mary E. Flowers (D), Rep. Elizabeth Coulson (R), Rep. Barbara Flynn Currie (D)
STAGE Effective 4/10/09
STATUS ACTIVE
PURPOSE Provides that under the medical assistance program, an immunosuppressive drug shall not require prior authorization, step therapy, generic substitution, or quantity limits without express written or oral notification and the documented consent of the practitioner and the patient.
Bill specific to immunosuppressant medication only. indiana BILL # No known legislation existing or recently introduced.
iowa
STATUS ACTIVE
PURPOSE Prescription Monitoring Program whose duties include respecting and preserving the integrity of the patient's treatment relationship with the patient's health care providers, and making recommendations regarding the continued benefits of maintaining the program in relationship to cost and other burdens to the patient, prescriber, and pharmacist.
kansas
BILL # No known legislation existing or recently introduced.
kentucky
BILL # No known legislation existing or recently introduced.
louisiana
BILL # SB154
DATE INT. 6/24/11
SPONS. Senator Ed Murray (D)
STAGE Effective 8/15/11
STATUS ACTIVE
PURPOSE Requires that certain healthcare coverage plans provide coverage for step therapy or fail first protocols.
maine
BILL # LD517, SP150
DATE INT. 4/15/11
SPONS. Sen. Thomas Saviello (R)
STAGE Committee on INSURANCE AND FINANCIAL SERVICES in House voted unanimously that the bill OUGHT NOT TO PASS. Means it wasn't forwarded to a vote on the floor. Placed in legislative dead files on 4/28/2011.
STATUS DEAD
PURPOSE This bill limits the ability of a health coverage carrier to require prescription drug formulary alternatives and prior authorization in certain circumstances beginning January 1, 2012.
maryland
BILL # No known legislation existing or recently introduced.
massachusetts
BILL # SB422
DATE INT. 1/20/11
SPONS. Sen. Barry Finegold (D)
STAGE Referred to Joint Committee on Financial Services Hearing, scheduled for 10/25/2011.
STATUS STALLED
PURPOSE A healthcare service plan contract that covers outpatient prescription drug benefits shall provide coverage for a drug that has been prescribed by a participating licensed healthcare professional for the treatment of pain and shall not require the subscriber or enrollee to first use an alternative prescription drug or an over-the-counter drug, but may require the subscriber or enrollee to first use a generically equivalent drug (if available).
michigan
BILL # No known legislation existing or recently introduced.
minnesota
BILL # No known legislation existing or recently introduced.
mississippi
BILL # SB2737
DATE INT. 1/17/11
SPONS. Sen. Terry Burton (R), Sen. Bob Dearing (D)
STAGE Effective 1/1/2012
STATUS ACTIVE
PURPOSE Prescriber shall have access to override when evidence can be shown step therapy route will be ineffective, likely to be ineffective, or cause harm to individual. Cannot be longer than 30 days when seen as ineffective.
missouri
BILL # HB821
DATE INT. 3/9/11
SPONS. Rep. Mike Bernskoetter (R), David Sater (R)
STAGE Passed in the House on 5/9/2011. Not displaying on any upcoming Senate calendars.
STATUS STALLED
PURPOSE Allows the prescribing physician to override any step therapy or fail first protocol when the treatment has been ineffective in treating the patient's disease or medical condition or based on sound clinical evidence or medical and scientific evidence that it is likely to be ineffective or will likely cause an adverse reaction or other harm. The duration of any step therapy or fail first protocol cannot last longer than 14 days. However, when the health carrier or the pharmacy benefit manager can show through sound clinical evidence that the originally prescribed medication is likely to require more than two weeks to provide any relief, the step therapy or fail first protocol may be extended up to seven additional days. ALSO, Requires a switch communication to clearly identify the originally prescribed medication and the medication to which it has been proposed that the patient should be switched; disclose any financial incentives that the pharmacy benefit manager or the prescribing practitioner may receive in the patient's decision to switch to a different medication; explain any clinical effects that the proposed medication may have which are different from the original prescription; advise the patient of the right to discuss the proposed change in treatment before a switch takes place, including with the patient's prescribing practitioner; and clearly identify any net change in the cost to the health insurance payer.
montana
BILL # No known legislation existing or recently introduced.
nebraska
BILL # LB1088
DATE INT. 1/21/11
SPONS. Sen. Abbie Cornett (R)
STAGE Indefinitely postponed on 4/14/11. Never came to vote on Senate floor. Not displaying on 2012 legislative agenda.
STATUS STALLED
PURPOSE The intent of LB1088 is that insurers and pharmacy benefits managers (PBMs) send notifications of request for medication changes to patients and their physicians or other prescribing health professionals whenever the insurer or PBM recommends changing a patient's medication to a different therapeutic agent. Among other things, this notification will: 1. Acknowledge that no medication change will be allowed without the authorization of the original prescribing health care professional. 2. Clearly identify the originally prescribed medication and the medication to which the patient would be changed. 3. Describe any financial incentives that may be provided or offered to the prescribing health care professional by the insurer or the PBM. 4. Describe any financial incentives that a health insurer or PBM may receive to encourage a medicine exchange. 5. Explain any cost-sharing changes for which the patient would be responsible should the medication change take place. 6. State that the insured has the right to discuss the propose medication change before it occurs.
nevada
LEGIS. Chapter 422, Section 403 of Nevada Revised Statutes (2009)
STATUS ACTIVE
PURPOSE The Drug Use Review Board of Medicaid program shall, by regulation, establish and manage the use by the Medicaid program of step therapy and prior authorization for prescription drugs.
NOTE: Applies only to Medicaid patients. new hampshire
BILL # SB171
DATE INT. 1/19/2011 in Senate, 3/17/11 in House
SPONS. Sen. Sharon Carson (R), Rep. Cindy Rosenwald (D), Rep. Frank Case (R), Rep. Nancy Stiles (R)
STAGE PASSED / ADOPTED WITH AMENDMENT in Senate on 3/23/11; voted INEXPEDIENT TO LEGISLATE by COMMERCE AND CONSUMER AFFAIRS committee in House on 5/25/11 ... no date was set to bring vote to House floor.
STATUS STALLED
PURPOSE This bill requires health benefit plans providing prescription drug benefits to provide an exception process which shall not take more that 24 hours for coverage for a medically necessary drug prescribed for the treatment of pain.
new jersey
BILL # A3968
DATE INT. 5/9/11
SPONS. Assemblyman Herb Conaway (D)
STAGE Reviewed by the Pension and Health Benefits Commission who recommended to not enact. No intention has been made to bring vote to House floor.
STATUS STALLED
PURPOSE Restricts health insurers from limiting access to pain medication.
NOTE: Bill specific to pain medication only. new mexico
BILL # SB536
DATE INT. 2/16/11
SPONS. Sen. Timothy Jennings (D)
STAGE Though Senate Finance committee voted to bring bill to floor, a desired amendment to the bill was not. Related or not, sponsor withdrew bill.
STATUS DEAD
PURPOSE Relating to health insurance; amending sections of the New Mexico insurance code, the health maintenance organization law and the nonprofit health care plan law to impose pricing controls on certain types of prescription drugs; providing for contingent applicability.
new york
BILL # A06049, S5110
DATE INT. 3/4/11
SPONS. Assemblyman Jonathan Bing (plus 31 others)
STAGE Referred to House Insurance committee on 3/4/11; enacting clause stricken on 7/11/11. No date set to bring vote to House floor.
STATUS STALLED
PURPOSE This bill would amend the insurance law by adding Article 33 which would prohibit fail first accident/or health insurance policies that require a patient to exhaust the least expensive drug options before insurers will cover more expensive treatment options. The bill would also prohibit switching patients to a different prescription drug without the full knowledge and consent of the prescribing physician and the patient, would require simple, common-sense steps to protect patients from the risks of ill-considered changes in their prescribed medicines. The bill would provide consumers with safeguards, transparency, and medical oversight that is necessary to ensure their health and safety.
north carolina
BILL # S718
DATE INT. 4/19/11
SPONS. Sen. Eric Mansfield (D), Sen. Louis Pate (R)
STAGE Was referred to Health Care committee on 4/20/11. No date has been set to bring vote to Senate floor.
STATUS STALLED
PURPOSE An act clarifying under what circumstances the substitution of generic prescription drugs is allowed under the Pharmacy Practice Act.
north dakota
BILL # No known legislation existing or recently introduced.
ohio
BILL # No known legislation existing or recently introduced.
oklahoma
BILL # No known legislation existing or recently introduced.
oregon
BILL # HB3541
DATE INT. 2/21/11
SPONS. Rep. Jim Thompson (R) (plus 28 others in House), Sen. Lee Beyer (D) (plus 11 others in Senate)
STAGE Referred to Health Care committee on 2/28/11. Still in committee upon adjournment on 6/30/11.
STATUS STALLED
PURPOSE Prohibits pharmacist from dispensing drug that is not therapeutically equivalent to drug ordered or prescribed unless prescriber and patient have consented in writing.
pennsylvania
BILL # No known legislation existing or recently introduced.
rhode island
BILL # HB5634
DATE INT. 3/3/11
SPONS. Rep. Peter Palumbo (D)
STAGE Committee recommended measure be held for further study on 3/30/11. No date was set to bring vote to House floor.
STATUS STALLED
PURPOSE Would allow for clinical judgment and patient choice within the bounds of accepted medical practice and would take precedence over payer costs.
south carolina
BILL # No known legislation existing or recently introduced.
south dakota
BILL # No known legislation existing or recently introduced.
tennessee
BILL # No known legislation existing or recently introduced.
texas
BILL # HB1405
DATE INT. 2/16/11
SPONS. Rep. John Smithee (R)
STAGE Effective on 9/1/11
STATUS ACTIVE
PURPOSE The refusal of a health benefit plan issuer to provide benefits to an enrollee for a prescription drug is an adverse determination for purposes of Section4201.002 if ... the enrollee's physician has determined that the drug is medically necessary.
utah
BILL # HB321
DATE INT. 2/10/11
SPONS. Rep. David Clark (R)
STAGE Enacting clause struck down 3/10/11. Returned to House Rules Committee with defeated bills.
STATUS DEAD
PURPOSE If, in the opinion of the prescribing practitioner, it is in the best interest of the patient that a therapeutic substitution not be dispensed for a prescribed drug, the practitioner may indicate a prohibition on a therapeutic substitution either by writing "dispense as written" or signing in the appropriate space where two lines have been preprinted on a prescription order and captioned "dispense as written."
vermont
BILL # No known legislation existing or recently introduced.
virginia
BILL # No known legislation existing or recently introduced.
washington
BILL # HB1876-2011-12
DATE INT. 2/8/11
SPONS. Rep. Tami Green (D), Rep. Phyllis Kenney (D)
STAGE 2011 1st special session by resolution reintroduced and retained in present status (4/26/11).
STATUS STALLED
PURPOSE An act relating to prohibiting insurers from creating specialty tiers for prescription drugs. Also sets limits for prescription co-pays.
west virginia
BILL # No known legislation existing or recently introduced.
wisconsin
BILL # No known legislation existing or recently introduced.
wyoming
BILL # No known legislation existing or recently introduced.
|
|||||||||||
|
|||||||||||
|
|
|||||||||||
