Patient Protections Added to Step Therapy Bill


The Legislature added several patient protection measures to a bill allowing “step therapy” for Medicaid drugs before passing the legislation early Monday morning.


Advocates for Kansans with mental illness and other conditions were pleased with the changes but remain concerned about the possible effects of the underlying bill on vulnerable patients.


Step therapy requires Medicaid patients to try the least expensive medications for treating their ailments first. If those fail, they can then “step up” to a more expensive alternative.


Gov. Sam Brownback’s administration wrote about $10 million in savings into its budget proposal under the assumption the Legislature would sign Medicaid step therapy into law.


The three insurance companies that administer KanCare, the state’s privatized Medicaid program, will decide how to impose the step therapy requirements, with guidance and oversight from the Kansas Department of Health and Environment and a Drug Utilization Review Board that includes doctors, pharmacists and other health care professionals.


Supporters of the bill, like Sen. Michael O’Donnell, a Republican from Wichita who chairs the Senate Health and Human Services Committee, said most commercial insurers use the practice.


But several House members, including Rep. Dan Hawkins, a Republican from Wichita, said those insurers generally only use step therapy for some classes of drugs and include a variety of patient protections.


Negotiations in a conference committee that Hawkins and O’Donnell led produced a revised bill that added some of those protections to the Medicaid plan.


The final bill exempted all medications prescribed before the law takes effect July 1 and placed a 30-day limit on the time patients may be required to use a cheaper multiple sclerosis drug.


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Wyandotte Daily Online       Published on May 3, 2016

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