Governor Tony Evers signed into law Tuesday in Janesville a Wisconsin Medical Society-supported bill designed to clarify health insurance industry procedures related to “step therapy.” The bipartisan legislation, first authored by Rep. John Nygren (R-Marinette) and Sen. Alberta Darling (R-River Hills) sets out clearer requirements insurers must follow when they create a step therapy protocol and requires certain exceptions to be granted when the prescriber submits complete, clinically-relevant written documentation supporting the request for specific patient care.
The Society’s Council on Legislation reviewed the original version of the bill and was helpful in providing feedback that led to modifications (a substitute amendment to the bill) shaping what eventually became 2019 Wisconsin Act 12. Society member Joanna Bisgrove, MD, also offered valuable insight on the need for the step therapy legislation during her testimony before a joint session of the Assembly and Senate health committees. The legislation was one of the most lobbied-upon bills so far this biennial session, with 35 different entities weighing in on the measure.
Contact Mark Grapentine, JD for more information.
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