Coalition Letter Asking Congress to Include Step Therapy Protections in Next COVID-19 Relief Package

04/20/2020

Thanks to recent efforts by Congress and the Administration, patients have already received a number of protections to ensure they have access to health care despite the enormity of the COVID-19 pandemic. While these measures have been critical in ensuring patients have access to health care and their medications in this time, further steps should be taken. We urge Congress to take additional action to support access to care by ensuring appropriate use of step therapy in Medicare Advantage (MA), Medicare Prescription Drug (PDP), Medicaid Managed Care (MCO) and ERISA plans by taking the following three actions:

  • Institute step therapy guardrails and protections for all MA, PDP and Medicaid MCO plans during the public health emergency (PHE).
  • Institute similar step therapy guardrails and protections for ERISA plans governed by the Department of Labor during the extent of the public health emergency.
  • Enact these same protections outside of the public health emergency for at least one year after end date of the PHE.

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