The National Psoriasis Foundation (NPF) applauds the passage of legislation in Delaware, Massachusetts, and Pennsylvania that will improve a person’s ability to access their treatments at an affordable price.
In Massachusetts, advocates have been pushing for step therapy protections for years. On November 1, 2022, Governor Charlie Baker signed HB 4929 into law, establishing a robust set of exceptions to bypass step therapy protocols when medically necessary, starting January 1, 2023. Thanks to these guardrails, people with chronic diseases and conditions will soon be able to better access the treatments and medications prescribed by their health care provider in a timely manner.
Step therapy is a utilization management tool used by health insurance companies that requires an individual to try and fail other, insurer-preferred medications before the individual will be granted coverage for the treatment originally prescribed by their health care provider.
“We are pleased to see that Massachusetts has become the 33rd state to enact legislation addressing the challenges created by step therapy protocols,” said Leah M. Howard, J.D., the president and CEO of NPF. “Many in our community, like Jody Quinn, have worked for years to make this a reality. Anyone who needs a treatment or medication to live their best lives owes these advocates a heartfelt ‘thank you.’”
Quinn is an NPF advocate who has been involved in efforts to pass step therapy reform in Massachusetts since 2017. “As someone who’s been through unnecessary step therapy protocols and experienced how the process can harm people, I’m glad that Massachusetts has decided to put sensible limits on step therapy,” she said. “This law will help people access the care they need when they need it, and I’m proud to have participated in the advocacy effort that got this bill passed.”
The victory in Massachusetts is only one of three major health care access breakthroughs in recent weeks. Pennsylvania passed SB 225, which ensures that state-regulated health plans respond to prior authorization and step therapy exception requests within 24 to 72 hours. The bill also includes other protections to make it easier for individuals to access their treatments.
Delaware became the 15th state to ban the utilization management practice of copay accumulators with SB 267. Copay accumulator programs are an increasingly common cost-shifting strategy used by insurance companies wherein third party copay assistance is not counted toward the consumer’s deductible, making critical treatments unaffordable for those who need them most.
Advocates who live with psoriasis, psoriatic arthritis (PsA), or other chronic diseases and conditions have proven to be incredibly effective messengers for driving action from lawmakers to improve affordable access to care. We at NPF thank the hundreds of folks who share their stories and write their lawmakers. You make this kind of change possible.
People need to hear your story too. Have you ever thought of lending your voice to make a positive change? It can be a very rewarding experience. Learn more.
Placing patient protections around step therapy protocols aligns with the aim of NPF to improve health outcomes for the more than 8 million individuals living with psoriatic disease in the U.S. To learn more about how NPF works to reform step therapy visit steptherapy.com.
About the National Psoriasis Foundation
Serving its community through more than 55 years of support, advocacy, research, and education, the National Psoriasis Foundation is the world’s leading nonprofit organization representing individuals with psoriasis and psoriatic arthritis. The NPF mission is to drive efforts to cure psoriatic disease and improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. As part of that effort, NPF created its Patient Navigation Center to offer personalized assistance to everyone with psoriasis or psoriatic arthritis. In recent years, NPF has funded more than $30 million in research grants and fellowships that help drive discoveries that may lead to better treatments and ultimately a cure. Learn more at psoriasis.org