Lets patients challenge health plan rules for prescription drugs
This bill would make plans create a clear, fast process for patients or their doctors to request an exception. If approved, coverage would be ensured for at least a year. Currently, plans can require patients to try certain drugs first.
Today, federal law does not explicitly require group health plans to offer a clear process for patients to get exceptions to "step therapy" rules. This means patients might have limited options to challenge a plan's requirement to try a different drug first. If this bill becomes law, group health plans would be required to set up a clear, fast process for patients or their doctors to request an exception. Plans would have to respond to most requests within 72 hours, or within 24 hours for urgent cases, and cover the prescribed drug for at least one year if an exception is approved.
S 2903 · 119th Congress · September 18, 2025 · AI Summary by gemini-2.5-flash · 9/10
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39 filings mentioned this bill
Amounts reflect total quarterly lobbying spend reported to the Senate, not bill-specific spending. Source: Senate LDA filings.