Bill
    SB 680
    
    
        85(R) - 2017    
    
    
        Senate Health & Human Services    
    
    
    
    
    
    
    
        Senate Health & Human Services    
    
    
    
            Department of Health
            Health & Human Services
            Healthcare
    
    
    
    Companion Bill
    HB 1464
    
     
    
        Vote Recommendation
        
            
                No            
            
                - 
                    Negative                
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                    Neutral                
- 
                    Neutral                
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                    Negative                
- 
                    Neutral                
 
     
    
            Author(s)
                    Kelly Hancock
        
    
    
    
    
    
    
    
    
    
        
Bill Caption
        Relating to step therapy protocols required by a health benefit plan in connection with prescription drug coverage.    
    
    
        
Fiscal Notes
        From the LBB: No significant fiscal implication to the State is anticipated.     
    
    
        Bill Analysis
        SB 680 would amend the Insurance Code to add that a health benefit plan issuer that requires a step therapy protocol before providing coverage for a prescription drug must establish and implement the step therapy protocol in accordance with clinical review criteria. A prescription provider would be able to submit a request for exemption from the protocol to the patient’s health plan provider. If the request is denied and appealed, an independent review from a utilization review agent would take place.  
     
    
        
        
Vote Recommendation Notes
        This legislation adds further regulation on top of an already heavily-regulated industry. It is not the proper role of the state government to regulate the process by which insurers manage their step therapy protocol or the process by which they handle appeals. This continues to grow the scope of government and violates our limited government principle. For these reasons, we oppose SB 680.