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Home » News » Health » Missouri Physicians Call for Legislation to...

Missouri Physicians Call for Legislation to Control Insurance Provider Interference in Prescription Decisions

April 2, 2015
Missouri Association of Osteopathic Physicians and Surgeons Supports Passage of House Bill 932 to Revise Step Therapy Protocols
Physician groups joined patients today at the State Capitol to call for restrictions on health insurer interference with the medicines physicians prescribe. House Bill 932 would redefine the laws for step therapy and give physicians and patients more control over prescribing and receiving recommended medications.

Step therapy is a protocol in which insurance companies require patients to “fail” on other medications or treatments before agreeing to pay for the medication originally prescribed by their doctor. In some cases, patients are required to fail multiple times before an insurer will pay for the prescribed medication.

The Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) has been the voice of osteopathic physicians in Missouri since 1897 and represents more than 3,000 osteopathic physicians statewide. They called for passage of HB 932 as a way to save health care dollars, ease patient suffering and restore the proper way of practicing medicine.

 “Step therapy is a dangerous process for patients and a frustrating one for doctors, as the insurer is directly interfering with the prescribed treatment plan,” said MAOPS Executive Director Brian Bowles. “Insurance companies are finding new ways to stall the filling of prescriptions and forcing people to take potentially less effective medication in order to increase profits.”

According to Bowles,MAOPS supports HB 932. “My hope is that the bill will bring a safer, more effective process for getting patients the medications they require to live healthy lives,” said Bowles. “In turn, this would allow the physicians, who have already established relationships with their patients, to make those decisions, rather than the insurers who don’t know the patient or their medical history and needs.”

Step therapy is a commonly used cost management tool, and in recent years, insurers have increased the use of step therapy. In 2012, approximately 65 percent of employer plans used step therapy, compared with 50 percent just two years earlier.[1]

“Imagine being prescribed the medication you need to manage your rheumatoid arthritis, epilepsy or chronic pain to only have it denied and replaced by a different drug all together by your pharmacist,” said Glenn Helverson, firefighter and board member of the Arthritis Foundation of Missouri. “My doctor knows my medical history and what medication will work best for my condition, not the insurers.”

HB 932 is sponsored by Rep. Sue Allen (R - St. Louis County). For more information, visit: www.house.mo.gov/billsummary.aspx?bill=HB932.

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