- Florida state legislators, business executives, and medical experts are advocating for two bills aimed at eliminating the step therapy mandate for mental health medications for Medicaid recipients.
- The bills, SB 112 and HB 183, seek to limit step therapy practices in treating mental and behavioral health.
- Step therapy is a treatment method that requires a patient to try a series of treatments, starting with the least expensive options, before moving on to more intensive treatments if necessary.
- The proposed legislation has received support from various organizations, including the Florida Psychiatric Society Legislative Task Force, who argue that step therapy protocols often result in minimal cost savings and can cause patients to go without necessary treatment.
In a show of support, state legislators, business executives, and medical experts joined forces on Wednesday to push for the passage of two bills aimed at eliminating the step therapy mandate for mental health medications approved by the Agency for Health Care Administration for Medicaid recipients.
Currently, the Senate bill has been referred to the Committee on Health Policy, the Appropriations Committee on Health and Human Services, and the Committee on Fiscal Policy. The House bill has been moved to the Healthcare Regulation Subcommittee.
Step therapy is a method of mental health treatment that requires a patient to try a series of treatments, typically starting with the least expensive and least invasive options, before moving on to more intensive treatments if necessary. This approach is commonly used in insurance-covered mental health treatments.
“We have many patients in the state of Florida that suffer from serious mental illnesses,” said Harrell. “We want to make sure that they don’t have to take various medications because they happen to be on a formulary that their insurance company or Medicaid has determined is the lowest priced medication and should be where they start.”
Harrell additionally took issue with the lengthy process that comprises step therapy protocols, claiming that if a first or second treatment option proves unsuccessful, it could take several months for an individual to receive proper treatment care.
“If you fail on [option] A, which may take six weeks, then you get to go to [option] B and another six or eight weeks. And then, maybe you go to [option] C, and again you may have another four, six, eight weeks before the insurance company or Medicaid determines that it’s not working,” she continued. “Think about the danger that is to the patient, and because this is mental illness, the possible danger to the public.”
Gonzalez Pittman presented findings from a recent study showing that one in four adults in Florida experienced mental illness in 2022 and that thirteen percent of young people in the state had at least one major depressive episode in the last year.
“Barriers to mental health care like step therapy prolong our state’s mental health crisis,” said Gonzalez Pittman. “This issue not only takes a toll on mental health patients and their families but on the state’s communities and economy.”
In her claim of economic effects, Gonzalez Pittman cited lengthy hospital stays, the loss of members of the state’s workforce, and the loss of life due to suicide.
The proposed legislation received additional backing from the Florida Psychiatric Society Legislative Task Force, with Chairwoman Debra Barnett speaking at the press conference. Barnett argued that step therapy protocols often result in minimal cost savings and reiterated that it can cause patients to go without necessary treatment due to prolonged wait times.
Julio Fuentes, President and CEO of the Florida State Hispanic Chamber of Commerce, also threw his support behind the bills and highlighted the financial burden imposed by step therapy. Citing a recent study, he revealed that step therapy practices cost taxpayers over $274 million annually via missed workdays, medical expenses such as pharmaceuticals, and inpatient costs.
“This legislation will leave a lasting impact on our state,” he said.