Maine House Democrats: Bill to Protect Patients Facing Step Therapy Receives Governor’s Signature

AUGUSTA, Maine, June 14 -- The Maine House Democrats issued the following news release on behalf of Maine State Rep. Charlotte Warren, D-Hallowell:

A bill sponsored by Rep. Charlotte Warren, D-Hallowell, to improve the current step therapy process was signed into law by Gov. Mills on Thursday.

Step therapy protocols require that a patient try and fail one or more medications before granting coverage for the treatment originally prescribed by their provider. These protocols are a cost containment tool frequently utilized by health insurance plans or pharmacy benefit managers.

"This detrimental practice by insurers can be a barrier to consistent access to the medicines that can help manage chronic, serious illness and disease," said Rep. Warren. In many instances the patient is required to step through as many as three or four different medications before receiving the medication their doctor deemed was best for them.

The bill ensures step therapy protocols are developed and implemented through a transparent process based on the most current clinical practice guidelines, and not price alone. It does not ban the use of step therapy, but rather works to ensure the process does not unintentionally harm a patient. It also provides a clear timeline within which insurers must grant or deny exception requests.

We need a uniform transparent policy in the state so that all patients receive the best treatment for their conditions, and this will not only accomplish that, but it will also help preserve the doctor/patient relationship, and provide important patient protections within the step therapy protocols, Warren added.

Warren is serving her third term in the House of Representatives. She is the House chair of the Criminal Justice and Public Safety Committee and represents Hallowell, Manchester and Gardiner.