Bill > S2119

This bill aims to regulate the use of step therapy protocols by health insurance carriers and utilization review organizations in Massachusetts. It sets requirements for the clinical practice guidelines and review criteria used to establish step therapy protocols, and requires carriers to have a clear and accessible process for patients and providers to request exceptions to the step therapy requirements. The bill also specifies the grounds on which a step therapy override exception must be granted, and requires timely responses to such requests. Overall, the bill seeks to ensure that step therapy protocols are based on appropriate medical evidence and do not unduly restrict patient access to needed medications.

https://malegislature.gov/Bills/190/S2119