Arkansas Becomes First State to Pass Comprehensive Step Therapy Reform Legislation in 2021

Portland, Oregon – Feb. 23, 2021

The National Psoriasis Foundation (NPF) applauds Governor Asa Hutchinson and the Arkansas Legislature for the passage of Senate Bill 99 (SB 99), now Act 97. This new law, which takes effect Jan. 1, 2022, will improve access to care for the 75,000 Arkansans living with psoriatic disease by updating step therapy protections and providing commonsense guardrails for step therapy protocols.

Proper management of chronic diseases, such as psoriasis, during the COVID-19 pandemic underscored the need for step therapy protections. Under current step therapy protocols, patients are required to try and fail medications selected by their insurance company before they are granted access to the treatment prescribed by their health care provider. For patients with complex and chronic conditions, step therapy can result in treatment delays, disease progression, and higher health care costs.

Senate Bill 99 ensures step therapy protocols are based on widely accepted medical and clinical guidelines. The bill also provides a clear process for health care providers and patients to submit an override exception request to the step therapy protocol. The exception will be granted if the mandated step therapy drug is contraindicated or likely to cause an adverse reaction, expected to be ineffective, was previously tried and failed, is not in the best interest of the patient, or if the patient is currently stable on another medication.  

Senate Bill 99 also includes a clear and timely process for insurance companies to respond to the exception request – 24 hours for emergency situations and 72 hours for non-emergency situations. If no response is received, the decision is made in favor of the patient.

Sponsored by Senator Cecile Bledsoe and Representative DeAnn Vaught, SB 99 was unanimously passed through both chambers and ensures Arkansans get the right treatment at the right time.

NPF state government relations manager, Kristen Stiffler, testified at the House Public Health, Welfare and Labor Committee hearing on behalf of the over 30 patient and provider organizations known as Arkansans for Step Therapy Reform.

“The passage of this bill represents significant progress for Arkansans living with chronic conditions,” Stiffler said. “NPF thanks Arkansas lawmakers and Governor Hutchinson for their commitment to improving health outcomes and quality of life for patients across the state. Senator Bledsoe and Representative Vaught should be applauded as passionate champions of step therapy reform.”

Arkansas is the first state to pass step therapy reform in 2021. With the passage of this bill, Arkansas now has one of the strongest step therapy protection laws in the nation.

NPF continues to work on behalf of all people living with psoriasis and psoriatic arthritis who cannot afford to delay access to the effective treatments prescribed by their health care provider. Placing patient protections around step therapy protocols will assist NPF to improve health outcomes for the more than 8 million Americans living with psoriasis and psoriatic arthritis. To learn more about how NPF works to reform step therapy visit


About the National Psoriasis Foundation

Serving its community through more than 50 years of patient support, advocacy, research, education and funding, the National Psoriasis Foundation, NPF, is the world’s leading nonprofit fighting for individuals with psoriasis and psoriatic arthritis. The NPF mission is to drive efforts to cure psoriatic disease and dramatically improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. As part of that effort, NPF created its Patient Navigation Center to offer personalized assistance to everyone with psoriasis or psoriatic arthritis. To date, NPF has funded more than $24 million in research grants and fellowships that help drive discoveries that may lead to more and better treatments and ultimately a cure. Learn more at

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