H.R. 2279 116th Congress House

Safe Step Act

Official title: To amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a pla… Show full official titleShow less

Official title: To amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide an exceptions process for any medication step therapy protocol, and for other purposes.

Introduced: April 10, 2019 Introduced by: Raul Ruiz Democratic · California See on congress.gov

Health Drug therapyEmployee benefits and pensionsHealth care costs and insuranceHealth care coverage and accessPrescription drugs

Everywhere this bill has been 2 steps

Introduced

In committee

Reported out

Passed House

Passed Senate

To President

Became law

Apr 10, 2019

Referred to the House Committee on Education and Labor.

Apr 10, 2019

Introduced in House

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Latest action April 10, 2019

Referred to the House Committee on Education and Labor.

Plain-English summary Congressional Research Service

Safe Step Act

This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer.

A request for such an exception to the protocol must be granted if (1) the treatment is expected to be ineffective, (2) the treatment will cause or is likely to cause an adverse reaction to the individual, (3) the treatment is expected to decrease the individual's ability either to perform daily activities or occupational responsibilities or adhere to the treatment plan, (4) the individual is stable based on the prescription drugs already selected, or (5) there are other medical reasons that warrant withholding the treatment.

The bill requires a group health plan to implement and make readily available a clear process for an individual to request an exception to the protocol. Requests must be granted no later than three days after receipt of the request. In certain cases where the life, health, and ability of the individual are jeopardized by the protocol, the request shall be granted no later than 24 hours after receipt of the request.

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