Wenstrup, Ruiz Legislation Gains Broad Support from Patient and Healthcare Provider Community
Washington, May 25, 2017
WASHINGTON, D.C. – Congressman Brad Wenstrup (R-OH) and Congressman Raul Ruiz (D-CA) received a letter of support from 27 cosigners in the patient advocacy and healthcare provider community in support of their bill, The Restoring the Patient’s Voice Act (H.R. 2077). This bipartisan legislation is designed to give providers increased autonomy in determining the care that is best for their patients.
“As advocates for the patient and healthcare provider communities across the nation, and the millions of individuals we collectively represent, we offer you our strong support for H.R. 2077. We believe this common sense, bipartisan solution will garner a positive impact on many individuals who struggle needlessly to manage their disease state and overall health,” the letter states.
“…As clinicians and legislators, you can attest that the physician-patient relationship is paramount and must be protected. The course of care prescribed by a physician, or other healthcare provider, is at the foundation of patient-centered care, and shared decision-making follows only after the patient and provider establish a relationship founded on trust. When healthcare plans seek to interfere with that decision-making and change the course of treatment, it jeopardizes a patient’s well-being, regardless of the disease state or medical concerns being treated.”
Full text of the letter is available here. Cosigners include:
· Academy of Integrative Pain Management
· The AIDS Institute
· Alliance for the Adoption of Innovations in Medicine (Aimed Alliance)
· Alliance for Patient Access
· Allergy & Asthma Network
· American Academy of Dermatology Association
· American Autoimmune Related Diseases Association
· American College of Rheumatology
· Arthritis Foundation
· Coalition of State Rheumatology Organizations
· Crohn's & Colitis Foundation
· Epilepsy Foundation
· The Florida Society of Clinical Oncology (FLASCO)
· Global Healthy Living Foundation
· Hemophilia Federation of America
· Hepatitis Foundation International
· ICAN, International Cancer Advocacy Network
· International Foundation for Autoimmune & Autoinflammatory Arthritis (IFAA)
· Lupus and Allied Diseases Association, Inc.
· Mended Hearts and Mended Little Hearts
· Miles for Migraine
· National Eczema Association
· National Headache Foundation
· National Infusion Center Association
· National Psoriasis Foundation
· U.S. Pain Foundation
Legislative background -- Currently, when a physician prescribes a particular drug treatment for a patient, the patient’s insurance company may require them to try a less expensive treatment, or series of treatments, first, before they can have access to the drug originally prescribed by their physician. The patient is not able to try the second treatment until the first one is proven to “fail.” This protocol is known as “step therapy” and is understandably deployed by insurance companies as they strive to control costs while maintaining quality care.
Unfortunately, step therapy protocols often ignore a patient’s medical history, such as whether they have already tried certain drugs under a different health insurance plan, or if they have other medical conditions that might interfere with the drug’s effect. It may also not take into account whether a certain drug’s side effects will impact the patient’s ability to perform their job, or if the patient would prefer a drug that has a different ingestion method or dosage form. While many insurance companies that utilize step therapy have a process for patients to receive exceptions, it can be unclear, resulting in excessive back and forth between the provider and the insurance company, and delaying care.
The Restoring the Patient’s Voice Act would require employer-sponsored health plans that utilize step therapy protocols to establish a clear, effective, and fair exceptions process to allow patients to bypass the step therapy requirements in limited circumstances.
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Office of Representative Brad Wenstrup