Massachusetts Medical Society: Letter to Governor Baker Regarding An Act Relative to Step Therapy and Patient Safety

Letter to Governor Baker Regarding An Act Relative to Step Therapy and Patient Safety

His Excellency Charles D. Baker
Governor of the Commonwealth of Massachusetts
State House
Boston, MA 02133

Dear Governor Baker:

On behalf of the Massachusetts Medical Society’s over 25,000 physician, resident, and medical student members, I write to urge your signature for H.4929, An Act Relative to Step Therapy and Patient Safety. This legislation is critical to ensuring patients receive timely and high-quality care.

Step therapy, or so-called “fail first” protocols require patients to try and fail one or more lower-priced medications specified by their insurance company – not their physician or health care provider – to treat their health condition. This one-size-fits-all approach is an imprudent attempt to control health care costs and it undermines the medical expertise of physicians while failing to adequately account for the characteristics and needs of individual patients. The step therapy process also wastes critical time in treatment – which many patients simply cannot afford to lose – diminishing the quality of care provided, and ultimately putting patients at risk. Fail first policies often result in forced drug switching, treatment gaps, and cessation of effective therapy, all of which negatively impact patients dealing with a wide range of medical conditions. These policies disparately harm patients of color, who are disproportionately impacted by certain chronic conditions, the treatment of which are often subject to step therapy.

This legislation will protect the physician-patient relationship, ensure fail first protocols are based on clinical guidelines, and will provide a transparent and expeditious appeals process, ultimately removing barriers and making care more accessible for patients. Importantly, the bill ensures that if a delay in treatment would result in significant risk to the patients’ health or well-being, the insurer must address step therapy exemptions or appeals within 24-hours. While this bill does not prohibit step therapy, it installs critical safeguards that will improve patients’ health and well-being.

For these reasons, on behalf of our members and most importantly, their patients, I strongly urge you to sign H.4929. Thank you for your consideration and please do not hesitate to reach out with questions.


Theodore A. Calianos, II, MD, FACS

View a PDF version of this letter here.

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