Earlier today, Governor Wolf signed legislation to improve access to care for cancer patients across the state. Senate Bill 225, now Act 146, is a vital new law that will curb restrictive prior authorization and step therapy practices imposed by health insurers.
Prior authorization requires physicians to obtain approval from insurers before prescribing medication or moving forward with a specific treatment. Physicians report that this process can lead to significant delays in care, contributing to negative outcomes in patients. Step therapy produces similar delays; this practice requires a patient to try, then fail, on alternative drugs selected by their insurance company before coverage is granted for the medication prescribed by the patient’s provider. Both prior authorization and step therapy protocols limit a provider’s ability to tailor care to individual patient needs.
Act 146 will create standards to reduce delays from prior authorization, make the process more efficient for providers—and patients, alike—and implement guidelines that make exceptions to step therapy more straightforward and the process more time-sensitive.
“Any delay in cancer treatment is an opportunity for the disease to progress or negative side effects to persist. Cancer patients cannot afford barriers to or delays in receiving lifesaving treatments and medications,” said Emma Watson, Pennsylvania Government Relations Director for the American Cancer Society Cancer Action Network (ACS CAN). “ACS CAN applauds PA legislators and Governor Wolf for prioritizing Pennsylvanians’ access to critical care. Act 146 is a great step towards streamlining and safeguarding access for cancer patients across the state.”
ACS CAN thanks Senator Kristin Phillips-Hill for her leadership on this critical legislation. ACS CAN looks forward to the impact this will have on health care delivery in Pennsylvania.
This story was published by American Cancer Society Cancer Action Network on November 3, 2022. It is republished with permission.