Safe Step Act

HR 2630, the Safe Step Act, requires group health plans and health insurance issuers to establish a clear, transparent process for patients or their doctors to request exceptions to medication step therapy protocols. These protocols typically force patients to try cheaper drugs first before covering more expensive alternatives. The bill mandates that plans must approve exceptions when prior treatments failed, delay would cause serious harm, a treatment is unsafe, or a patient is stable on a previously approved drug, with strict 72-hour (or 24-hour in emergencies) decision timelines. It also requires plans to publish the exception process online and limit documentation requests to only necessary medical information. This law directly affects health insurers, employers offering health plans, and patients using step therapy for prescription drugs.