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Minutes for SB93 - Committee on Public Health and Welfare

Short Title

Establishing restrictions on the use of step therapy protocols by health insurance plans.

Minutes Content for Mon, Feb 25, 2019

Chairperson Suellentrop opened the hearing on SB93.  Scott Abbott, Staff Revisor, gave an overview of the bill.

Representative Eric Smith gave proponent testimony for SB93, speaking about the experience of step therapy protocol in regards to his wife living with Multiple Sclerosis. He urged support of this bill to limit the amount of time that an insurance company can delay treatment and provide reasonable explanations for why an experts orders should not be followed. (Attachment 1)

Kari Rinker testified as a proponent of SB93 stating that the bill proposes to improve the laws regarding step therapy protocols for prescription drugs. Under step therapy protocols, for a given diagnosis, insurers cover specific drugs in a specific order, meaning an individual must be prescribed medications in the step order so that they are covered by the insurer. (Attachment 2)

Dr. Mark Box, a practicing rheumatologist in the Kansas City area for 25 years, supports the passage of SB93. He testified that the passage of SB93 would ensure that step therapy exemptions will be clinically grounded and transparent and that the bill would allow for providers to provide insurance plans with relevant documentation from a patient's medical history to support a step therapy exemption request. (Attachment 3)

Stacy Penner gave proponent testimony in support of SB93. As an occupational therapist she is familiar with the clinical side of arthritis. She knows personally the battles and struggles with arthritis as both the parent of a child with polyarticular juvenile arthritis and she, herself has been diagnosed with rheumatoid arthritis and osteoarthritis. Open enrollment for her insurance brings about constant fear that something will change and that her daughter might have to go through step therapy again. In her own case it took 7 weeks and many phone calls from herself, her doctor and her pharmacist to gain approval of a medication because the insurance company did not want her on the medication. She stated that the doctors know the best treatment plan for their patients, not a health plan's step therapy policies. (Attachment 4)

Dantia McDonald, in her proponent testimony for SB93, shared her story of suffering from a condition called anosognosia. For seven years she could not tell reality from imagination. She finally switched to medication that helped her become delusion free in three days. It is her fear that in changing her health plan due to marriage and/or a job change, she may be forced to go through step therapy and develop both delusions and anosognosia once again. (Attachment 5)

Gayle Taylor-Ford, a proponent of SB93 told of her husband's experience when he was diagnosed with Multiple Sclerosis in 2015. Due to having to obtain prior authorization to obtain coverage for the type of therapy he needed, it was several weeks before he was able to begin the medication he needed. After his 90 plus day wait until his first treatment, a new MRI was done. It showed two new lesions that had developed on his spinal cord. She stated that is why he in now in a wheel chair. Since taking the medication he has not developed any new lesions to this day. (Attachment 6)

Stephanie West-Potter spoke as a proponent of SB93, not only as a representative of the Disability Rights Center of Kansas but also as a person with bipolar disorder. It took her 10 years, 6 psychiatrists, and over 20 medications to find the right medication. The passage of SB93 is crucial for stability and survival. She said people shouldn't have to suffer through months of a cheaper medication in order to earn the ability to take what can save their lives. (Attachment 7)

LuGina Mendez-Harper gave opponent testimony of SB93 stating that it provides an avenue to circumvent step therapy which will result in higher drug costs for employers, state governments, health plans, and Kansas residents. The passage of SB93 will raise health care costs for Kansas citizens with no benefit to anyone except pharmaceutical manufacturers. (Attachment 8)

Questions were asked by committee members.

Written only proponent testimony was submitted by:

Tally Bell, Neurology Consultants of Kansas (Attachment 9)

Meg Godderz, Member, National MS Society (Attachment 10)

Josie Peterson, Movement Disorders Policy Coalition (Attachment 11)

Brian Kennedy, Alliance for Patient Access (Attachment 12)

Angie Thies, National Psoriasis Foundation (Attachment 13)

Sara Prem, American Lung Association (Attachment 14)

Peggy Johnson, Susan G. Komen - Kansas (Attachment 15)

Timothy Shaver, MD, Arthritis and Rheumatology Clinics of Kansas (Attachment 16)

Michele Guadalupe, Arthritis Foundation (Attachment 17)

Suzanne Olbricht, American Academy of Dermatologists (Attachment 18)

Madelaine Feldman, Coalition of State Rheumatology Organizations (Attachment 19)

Jordan Feuerborn, American Cancer Society, Cancer Action Network (Attachment 20)

Rebecca Kirch, National Patient Advocate Foundation (Attachment 21)

Amy Campbell, Kansas Mental Health Coalition (Attachment 22)

Written only opponent testimony was submitted by:

Larrie Ann Brown, Cigna (Attachment 23)

Chairperson Suellentrop closed the hearing on SB93.

Chairperson Suellentrop adjourned the meeting at 10:40 a.m.