HB 450 – Reduce Barriers to Improve NC Health and Safety (Step Therapy)

HB 450 – Reduce Barriers to Improve NC Health and Safety (Step Therapy)

Primary Sponsors: Rep. Larry Potts (R-Davidson), Rep. Josh Dobson (R-Avery), Rep. David Lewis (R-Harnett), Rep. Wayne Sasser (R-Stanly)

Bill Summary

The bill states that a health benefit plan that provides coverage for abuse deterrent opioid analgesic drug product only if the health plan imposes the same prior authorization requirement for each opioid analgesic drug product without an abuse deterrence labeling claim.

The bill states that no health benefit plan that provides coverage for abuse deterrent opioid analgesic drug products may require the use of an opioid analgesic drug product without an abuse deterrence labeling claim before authorizing use.

Clinical review criteria used to establish a step therapy protocol would include the following requirements:

  • Recommend that prescription drugs be taken in the specific sequence requirements
  • Developed and endorsed by an independent multidisciplinary panel of experts not affiliated with a health benefit plan or utilization review organization
  • Based on high quality studies, research, and medical practice
  • Created by an explicit or transparent process that includes
    • Minimizing biases and conflicts of interest
    • Explains the relationship between treatment options and outcomes
    • Rates quality of evidence supporting recommendations
    • Considers relevant patient subgroups and preferences

The bill also includes an exception process.

Bill Movement

This bill was filed on March 26, 2019.

This bill was referred to the following committees:

  • Health – heard for discussion only on April 16, 2019
    • Passed May 2, 2019
  • Rules
    • Passed May 3, 2019
 
 

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