The Florida Senate on Thursday unanimously passed a bill that would allow Medicaid beneficiaries with “serious” mental illness to avoid a drug practice known as step therapy.
Step therapy generally involves requiring a patient to try one type of medication to determine if it is effective before being able to try a more-expensive drug.
The bill would allow Medicaid beneficiaries with conditions such as bipolar disorder, major depressive disorders and schizophrenia to be able to avoid step therapy if their physicians submit documentation about the medical necessity.
“I think this is a major step forward in how we are dealing with a significant (mental health) crisis that we have,” bill sponsor Gayle Harrell, R-Stuart, said. An identical bill (HB 183) is pending in the House Health & Human Services Committee.
Details On Step Therapy
Step therapy, also known as fail-first therapy or step protocol, is a type of prior authorization requirement that is used by some health insurance plans to control the costs of prescription drugs.
Under step therapy, a patient must try a less expensive drug before they can be prescribed a more expensive drug. The goal of step therapy is to ensure that patients are only taking the most expensive drugs when they are absolutely necessary.
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Step therapy is controversial, with some people arguing that it can be harmful to patients. For example, a patient who is allergic to a less expensive drug may be forced to try it anyway before they can be prescribed the drug that they need.
Additionally, step therapy can delay the time it takes for patients to get the medication they need, which can have serious consequences for their health.
If you are concerned about step therapy, you should talk to your doctor. They may be able to work with your insurance company to get you the medication you need without having to go through step therapy.
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