House Human Services Committee Puts Patients Health Ahead of Insurer’s Bottom Line

Lawndale News Chicago's Bilingual Newspaper - Business

Patient groups from across the state are praising the Illinois House Human Services committee for passing a key piece of legislation aimed at ensuring that patients have access to the specific medications their doctors say they need.

HB 3549, proposed by Representative Laura Fine (D-17th district) curbs an insurance industry protocol known as step therapy. Using step therapy, insurers can require patients to try and fail on a series of medications before being allowed to have a medication that their doctor has prescribed for their individual medical condition.

“Doctors know what’s best for their patients” said Esther E. Sciammarella MS, Executive Director of the Chicago Hispanic Health Coalition. “When treating complicated medical issues like some of our patients face, a personal understanding of an individual’s medical condition is critical. Patients can’t be treated effectively when doctors are limited as to what medications they can prescribe. “

HB 3549 was passed out of committee unanimously with bi-partisan support. Committee members heard from patients and doctors about the ways step therapy can impact patients. Advocates are urging for continued support and swift action on the legislation when lawmakers return from their spring recess.

HB 3549 does not ban step therapy, but rather gives healthcare providers a clear process by which to appeal the process. The bill does not limit the number of steps an insurer can impose nor does it prioritize the prescribing of brand name drugs over generics.

“This is common sense legislation that puts the power of prescribing where it should be—in doctor’s hands, said Ms. Sciammarella. “Patients in Illinois will be better served by this legislation, and healthcare costs will continue to be contained.”

Similar legislation has been passed in states across the country, including Connecticut, Kentucky, Texas and Louisiana. HB 3549 now heads to the House of Representatives for a floor vote.

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