Legislative Spotlight
Welcome to our new Legislative Spotlight feature! Here, we will highlight a healthcare bill that needs our help to either pass or to be defeated. The featured bills will mainly come to us from the state legislatures, but sometimes we will include a federal bill. All of these bills will be of high impact to the chronic and autoimmune communities, and we will be asking you to take action with us in opposition or support.
Bill of the month: utilization management transparency act (oregon sb 139)
This legislation creates new requirements regarding prior authorization, step therapy and other practices that could be harmful for patients.
Allows providers to act on behalf of patients when a treatment requiring prior authorization* is subjected to a step therapy plan**, drug protocol, or other restricted review process over the provider’s treatment recommendation
Prior authorization need only be renewed every 90 days, not every 30 days
Requires health insurers to report certain information on requests for prior authorization
*Prior authorization is when an insurance company requires notice and a process wherein an insurer can authorize or deny a medication, procedure, or other treatment prescribed by a doctor.
**Step therapy is when the insurance company denies coverage for a treatment prescribed by a doctor in favor of less expensive options that may not be effective. This harmful practice could result in a patient’s condition worsening before they are treated effectively, or even missing a vital window of treatment wherein optimal outcomes are no longer possible.
Take ACTION
Readers, this is where you come in! Oregon residents, contact your state senator and representative and let them know know you support the bill. Not an Oregon resident? Reach out to any friends and family that are and urge them to contact their legislators.
In the News:
Health Care Bills Are Rolling In (Portland Business Journal)
