Safe Step Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The Safe Step Act amends the Employee Retirement Income Security Act (ERISA) to require group health plans and health insurance coverage to establish a clear process for participants or beneficiaries to request an exception to medication step therapy protocols. This process must be prompt, transparent, and allow for the presentation of clinical information. The bill also outlines specific circumstances under which an exception can be granted, such as ineffective treatments, potential severe consequences, contraindications, or functional ability impacts, and sets timelines for responses and expedited reviews in critical cases.
Key provisions
- Requires group health plans and insurers to implement a process for medication step therapy exception requests.
- Specifies circumstances for exception approval, including treatment ineffectiveness, potential harm, and functional ability impacts.
- Mandates a clear, prompt, and transparent exception request process with defined timelines for responses.
- Requires plans to provide information about the exception process to participants and beneficiaries.
- Establishes a one-year duration for granted exceptions.
- Defines ‘medication step therapy protocol’ for the purpose of the bill.
- Requires reporting of exception requests and outcomes to the Secretary of Labor.
- Sets a timeframe for the Department of Labor to issue implementing regulations.
Who is affected
- Individuals with health insurance coverage
Bill text
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