California Bill Would Bar ‘Step Therapy’ in Plans for Chronic Pain Patients
On Tuesday, the Assembly Health Committee considered AB 1144, a bill by Assembly member Curren Price (D-Inglewood) that would bar health insurers from using so-called "step therapy" for chronic pain patients, ABCNews.com reports.
Under step therapy, treatment begins with the treatment considered to be the safest and most cost-effective option. If the treatment is ineffective, insurers will cover more expensive and riskier treatment options.
Supporters of step therapy say the practice helps reduce risks for patients and boost efficiency throughout the health care system, but critics say the practice can lead to preferred treatment options being inaccessible for some patients.
Robert Takemoto -- president and CEO of Ventegra, a Glendale-based managed care contracting service -- said banning step therapy could push health care payers to scale back other benefits, raise copayments or deductibles, or eliminate prescription drug coverage altogether.
New Jersey already has barred step therapy (Childs, ABCNews.com, 4/22).
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