Safe Step Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- 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 issuers to establish a clear process for participants and beneficiaries to request exceptions to medication step therapy protocols. This process must be prompt, transparent, and allow for the submission of relevant medical information. The bill also outlines specific circumstances under which an exception can be granted, such as ineffective treatments, potential severe consequences, contraindications, or functional limitations, and sets timelines for responding to exception requests.
Key provisions
- Requires group health plans and insurers to implement an exceptions process for medication step therapy protocols.
- Establishes a 72-hour response time for initial determinations or requests for additional information regarding exception requests.
- Defines specific circumstances for exception approval, including treatment ineffectiveness, potential harm, and functional limitations.
- Mandates a clear and transparent process for submitting exception requests, including standardized forms and electronic submission options.
- Requires plans to provide readily available information about the exceptions process to participants.
- Sets a minimum one-year duration for coverage granted through an exception.
- Requires reporting of exception requests and outcomes to the Secretary of Labor.
- Establishes a timeframe for the Secretary of Labor to issue final regulations implementing the bill's provisions.
Bill text
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Sponsors
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