Born Discusses Recently Adopted ‘Step Therapy’ Legislation

(Madison) A bill signed by Governor Tony Evers this week is aimed at helping to improve transparency when it comes to insurance for serious conditions. The legislation limits ‘step therapy,’ and requires that insurance providers be more open about their requirements for using less costly methods to treat diseases when more expensive treatments are recommended by doctors.

State Representative Mark Born recently discussed the matter with us on WBEV’s Community Comment. The Beaver Dam Republican says rather than requiring someone to try something that is a policy of the insurance company, it will allow the doctor to bypass that so patients can work directly with their doctors to get the treatment or prescriptions they need.

Under the new law, insurers will be required to not only provide clear explanations as to why step therapy is being required, but also gives patients a way to seek an exception. We asked Born if insurance companies should ever be playing doctor. He says there should be a standard for services that are “covered” by an insurance company. Born says this bill looks at the good examples of where regulations are getting in the way and there was bi-partisan support to get that regulation “out of the way.”

Evers says the bill places some of the control back into the hands of healthcare providers and patients to decide the best treatment regimen for their medical condition. The bill was signed alongside another bill that loosens restrictions on dialysis equipment and supplies. Both bills received bipartisan support through the Legislature.