Safe Step Act

The Safe Step Act would amend federal health insurance law to require group health plans and insurance companies to create a mandatory exceptions process for step therapy protocols. Step therapy is a cost-control practice where insurers require patients to try one or more lower-cost medications before covering the specific drug their doctor prescribed. If enacted, this bill would allow patients and their healthcare providers to request exceptions to these requirements through a clear, transparent process. The bill specifies that insurers must grant exceptions in certain circumstances, such as when previously required treatments have been ineffective, when delaying treatment could cause severe harm, or when the required medication causes side effects that prevent a patient from safely performing their job or daily activities. Insurers would be required to make decisions on standard exception requests within 72 hours and on urgent requests within 24 hours. The bill currently has bipartisan support in the Senate and is under consideration by the Committee on Health, Education, Labor, and Pensions.