SB1084- Relating to Health Care Protocols
On Tuesday, January 19th, SB 1084, relating to Health Care Protocols, by Senator Don Gaetz (R-Destin) was heard by the Senate Banking and Insurance Committee  and passed with 10 yeas and 0 nays. AIF’s General Counsel, Tammy Perdue, spoke in opposition of this bill.

SB 1084 requires Medicaid managed care plans, health maintenance organizations (HMOs), and insurers that restrict medications by a step-therapy or fail-first protocol to have a clear and convenient process to request an override of the protocol. The bill requires these entities to grant an override of the protocol within 24 hours if, based on sound clinical evidence or medical and scientific evidence, the prescribing provider:

• Concludes that the preferred treatment required under the fail-first protocol has been ineffective in the treatment of the enrollee’s disease or medical condition; or
• Believes that the preferred treatment required under the fail-first protocol is likely to be ineffective given the known relevant physical or mental characteristics and medical history of the enrollee and the known characteristics of the drug regimen or will cause or is likely to cause an adverse reaction or other physical harm to the enrollee.

AIF believes this action to be redundant and unnecessary given that insurers already have a protocol in place if incidents, such as ineffective treatment of the enrollee’s disease or medical condition, occurs.

SB 1084 will now go to Senate Health Policy Committee.

AIF opposes legislation that will negatively impact the standards of care that are currently in place based on real-time protocols that are centered on evidence-based research.

AIF’s General Counsel, Tammy Perdue, released this statement regarding step-therapy:

AIF Statement in Opposition of Step Therapy Legislation

Tallahassee, Fla. – The Associated Industries of Florida (AIF) today released the following statement attributed to its General Counsel Tamela Perdue in opposition to Senate Bill 1084, which would change the current, effective method of prior authorization, step therapy and fail-first protocols.

“AIF today opposed SB 1084 because it would negatively impact the standards of care that are currently in place and based on real-time protocols that are centered on evidence-based research.  By changing the current, effective methods – which are used for the safest, most cost-effective drug and permit processing – it would force insurers and consumers to purchase the most expensive drugs and treatments even when equally effective drugs and treatments are available at much lower costs.

“AIF supports continued flexibility for health plans to ensure consumers receive high quality, high value and affordable care, through continued use of innovative plan designs to achieve this balance.  AIF opposes this legislation because we believe it would only increase costs, regulation and bureaucratic red tape.”

Senate Bill 1084 has also been referred to the Senate Committee on Health Policy and Senate Appropriations.

For more information on AIF, please visit AIF.com and follow @VoiceofFLBiz.

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