Gov. Kevin Stitt has signed Senate Bill 509, an important limitation of health insurance companies’ ability to override the best judgments of physicians.
The new law rebalances power over medical treatment, returning sovereignty to patients and their physicians.
Previously, insurance companies were able to mandate step-therapy protocols, which required patients to fail first on certain (presumably cheaper) drugs before they could get access to provider-preferred treatments. That means insurance companies were making critical prescription decisions, not doctors and the patients.
After Jan. 1, 2020, insurance plans will be required to use “recognized, evidence-based and peer-reviewed clinical practice guidelines” in their step-therapy protocols and provide a “clear, convenient and readily accessible process” for exceptions to those rules.
Insurance companies won’t be able to force patients to stop using effective drugs to comply with new step-therapy policies, and they will be required to grant exceptions for patients who are likely to have adverse reactions or if their physician thinks the insurance company’s drug won’t do the job.
Exceptions also will be required if the physician thinks the step-therapy drug “is not in the best interest of the patient, based on medical necessity.”
Oklahoma patients deserve what their physicians think is the best medical treatment, not what their insurance company thinks is good enough.
We congratulate the bill’s authors — Sen. Dave Rader and Rep. Cyndi Munson — and Gov. Stitt for standing up for sick Oklahomans. This is certainly a step in the right direction.
Scott Meador with the Tulsa Health Department explains what is done during mosquito season in Tulsa. Stephen Pingry/Tulsa World