Step Therapy Protocols

On May 19, 2018, Gov. Dayton signed HF 3196 into law, creating Chapter 162. This bill adds new provisions relating to step therapy for prescription drugs.

As background, step therapy involves protocols or programs that establish a specific order in which prescription drugs are prescribed. This bill requires plans that cover prescription drugs through step therapy to allow participants and their practitioners to request step therapy override exceptions. Specifically, the participant must be allowed to request, in writing, that step therapy be overridden in a particular situation where immediate coverage of prescription drugs would be more medically appropriate. The override exception requests must be granted if the plan participant previously received step therapy that was ineffective or caused a diminished effect or adverse event.

This law is effective Jan. 1, 2019.

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