Victory in California – Breaking Down Step Therapy Barriers!
For those living with arthritis and those fighting to conquer it, there are no shortage of barriers, bottlenecks and even days where No becomes the norm. As part of our efforts to fully support the arthritis community and break down those barriers to achieve more moments of Yes, we fight on many levels, including legislative, to make real change that impacts the lives of the over 50 million people living with this disease. Today, we celebrate a big victory for the 5.9 million people (38,000 of whom are children) in California living with arthritis.
Today we celebrate the passage of Assembly Bill 374, which places unprecedented levels of accountability on insurers around prior authorization and step therapy in CA. Before the passage of this landmark bill, insurers had free rein to handle and process provider requests in an unregulated fashion. This led to frequent delays in approval and denial of requests by doctors to prescribe medication for people living with arthritis, and more importantly, delays for patients in receiving the critical treatments they need.
With the passage of Assembly Bill 374, providers can fill out a form to bypass step therapy requirements altogether, speeding up the process in which patients get the care they need to live better. Under the new law, once insurers receive a prior authorization request, they have 72 hours to respond with an approval or denial. If the request is deemed urgent, the plans would have 24 hours to answer the request. To eliminate as many bottlenecks as possible, if an insurer fails to respond within the allotted time period, the request is automatically approved.
This victory means that children in California like Zane Breier won’t have to fight so long or so hard to get the treatment they need. Victories like today’s mean we’re making headway in the fight to help our community live better.
Thank you to our strong and ever-present team of Advocates and Ambassadors for joining us in the fight to make change for those living with arthritis.
Today we celebrate the passage of Assembly Bill 374, which places unprecedented levels of accountability on insurers around prior authorization and step therapy in CA. Before the passage of this landmark bill, insurers had free rein to handle and process provider requests in an unregulated fashion. This led to frequent delays in approval and denial of requests by doctors to prescribe medication for people living with arthritis, and more importantly, delays for patients in receiving the critical treatments they need.
With the passage of Assembly Bill 374, providers can fill out a form to bypass step therapy requirements altogether, speeding up the process in which patients get the care they need to live better. Under the new law, once insurers receive a prior authorization request, they have 72 hours to respond with an approval or denial. If the request is deemed urgent, the plans would have 24 hours to answer the request. To eliminate as many bottlenecks as possible, if an insurer fails to respond within the allotted time period, the request is automatically approved.
This victory means that children in California like Zane Breier won’t have to fight so long or so hard to get the treatment they need. Victories like today’s mean we’re making headway in the fight to help our community live better.
Thank you to our strong and ever-present team of Advocates and Ambassadors for joining us in the fight to make change for those living with arthritis.
Related Resources:
- Learn more about how you can join the movement and become an Arthritis Advocate
- Arthritis Foundation Helps Achieve a Big Victory in One Boy's Fight Against Arthritis
- Take a Closer Look at AB 74
