dahlia in my garden: Rio Fuego in Coleus leaves

Friday, May 20, 2011

Call to Action: Update on the fight against ‘Fail First’ policy Your help needed if you live in CA, CT, or NY

(I'm posting a day early because your help is needed on this important issue right away!)

‘Fail First’, also known as Step Therapy, is an unethical prescription practice used by some health insurance plans. The insurer requires that other treatments must be tried and must fail before the pain patient can get the drug originally prescribed by their doctor. Some individuals are required to try and fail five times before they receive the meds they were supposed to get in the beginning. 

Delaying or denying access to treatment steals time and quality of life from patients, could permanently worsen their conditions, could create serious new health crises, and potentially result in premature deaths. Insurers should not be making medical decisions; it should be between you and your physician!

To learn more about why we must get legislation passed in each state to stop it, read my previous blog post:  We must stop ‘Fail First’!

There’s also an excellent news video about how this terrible policy affects pain patients. Please take a quick moment to watch: Paying for Pain 


~CALIFORNIA: AB 369 moves another step, your support is needed THIS WEEK!
AB 369 prohibits a health plan from requiring a patient to try and fail on more than two medications before allowing the patient to have the pain medication prescribed by their doctor. This bill also allows a doctor to determine the duration of any step therapy or fail first protocol.
We passed AB 369 through the Assembly Health Committee on a 13-5 vote on April 26th.  One big hurdle down! This bill, authored by Assembly Member Jared Huffman, will be considered before the Assembly Appropriations Committee on Thursday, May 26th

We need your support letters NOW!! If you would like to assist getting this bill through Assembly Appropiations, we need you to send another signed letter of support. Please make the effort to take just a little time to make your voice heard! This policy could hurt you... or someone you love. We need to stop it! For details on sending a support letter, go here: How You Can Support AB 369

To read a news article about California’s bill, click here: 

~CONNECTICUT: Senate Bill 1083 heads for the final vote!

Last week, Connecticut's Senate Bill 1083, an act concerning health insurance coverage of prescription drugs for pain treatment, moved one-step closer to becoming a law. Passing through the general assembly 40-13, SB 1083 will now head to the floor of the Senate for one final vote. 

This could potentially be a huge win for the pain community, as this bill prevents an insurer from requiring the use of over-the-counter medications when a physician has already determined that such medications would be ineffective.

We need your help to guarantee SB 1083 becomes law by reiterate that step therapy or fail first policies are issues that we as pain survivors live with everyday. Unfortunately, many health insurance companies and some pharmacies have hired lobbyists to fight the passing of this bill and they are working tirelessly to negate our message: every patient deserves access to proper care and treatments that will help them manage their condition. 

To find out more about how to help in Connecticut, click here: 

~NEW YORK: Assembly bill A6049 / Senate bill 5110
On May 10, 2011, the Global Healthy Living Foundation (GHLF) held a successful Advocacy Day, spearheading a coalition of advocacy groups who gathered in Albany and spoke to representatives in favor of Fail First/Step Therapy Reform Bills in the legislature. 

Joining GHLF in their efforts to represent patient interests in the Capitol were representatives from the US Pain Foundation, the American Pain Foundation and ABRUD (American Brotherhood for Disabled and Elderly people). Several organizations wrote letters of support, which were presented to Assemblymembers and Senators, including the American Cancer Society, Dysautonomia Foundation, National Alliance on Mental Illness-New York State Chapter, National Psoriasis Foundation, and New York State Osteopathic Medical Society.

The bill will soon be headed to the Insurance Committees in the NYS Assembly and Senate, and there is still advocacy work to be done in the meantime! Write a letter of support or contact Alexey Salamakha (asalamakha@ghlf.org) to find out other ways to show your support. Read more here about Advocacy Day
~Do you know another state with a ‘Fail First’ bill pending?
If you are fighting ‘Fail First’ in your state and have a bill moving through your legisltature, please send me links and articles so I can highlight your battle and hopefully help you to pass it into law.

Thanks to Fail First Hurts, the Reflex Sympathetic Dystrophy Association, and For Grace for providing the information to write this blog post.

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