Safe Step Act requires group health plans to implement an exceptions process for medication step therapy protocols.
The Safe Step Act amends the Employee Retirement Income Security Act of 1974 to mandate that group health plans and health insurance issuers offer a clear, prompt, and transparent process for exceptions to medication step therapy protocols. These protocols require patients to try alternative drugs before receiving coverage for their prescribed medication. The bill specifies circumstances under which exceptions can be granted, such as when required treatments are ineffective or contraindicated. Plans must respond to exception requests within 72 hours, with expedited reviews for urgent cases.
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