Safe Step Act mandates a clear exceptions process for medication step therapy protocols in group health plans and health insurance coverage.
The Safe Step Act amends the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers to implement a clear, prompt, and transparent process for exceptions to medication step therapy protocols. This process must allow participants or beneficiaries to request exceptions based on specific criteria, such as ineffective treatments or adverse reactions. Plans and issuers must respond to requests within 72 hours, either approving the exception or requesting additional information.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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