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Scott Lipps (R-Franklin, center) talks about his experience as “step therapy” bill sponsors Rep. Nickie Antonio (D-Lakewood, far left), Sen. Peggy Lehner (R-Kettering, second from left) and Sen. Charleta Tavares (D-Columbus, far right) look on. [Karen Kasler | Statehouse News Bureau]

Lawmakers Try Final Push On Bill To Regulate “Step Therapy” By Insurers

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A bipartisan bill dealing with how insurance companies deny certain treatments and drugs until other options are tried first is getting a final push in this lame duck session. And there’s a lawmaker who’s joining in on this effort – but as a patient.

It’s called “step therapy” – where insurers deny a drug or treatment until a different, sometimes cheaper option is tried first.

Rep. Scott Lipps (R-Franklin) came face to face with it after fell seriously ill and was denied the drug his specialist had prescribed in favor of a medication he says did nothing but cost him recovery time. “I learned this new term ‘step therapy’ in a very negative personal matter. And when I learned I had colleagues working on this issue, I was standing behind them cheering them on,” Lipps said.

Lawmakers say they want to ensure there’s a clinical reason for step therapy, and that it’s not just to save money. Health plans have opposed this bill, saying step therapy ensures safer, more cost-effective drugs are used first.