Trending News Today: Patient Advocacy Groups Call on Legislators to Restrict Step Therapy

Kentucky became the first state approved to implement work requirements for Medicaid enrollees, according to Kaiser Health News. Conservatives believe that the requirement can give individuals an incentive to work and eventually leave the program, while Democrats and other groups said it can cause interruptions in health coverage. Gov Matt Bevin said that the decision to enact the work requirements was because Medicaid-insured Kentuckians want to work and have a path upward, according to the article.

Step therapy is used to encourage the use of less costly drugs before moving on to newer, and typically more costly, treatments. Patient advocacy groups have criticized this policy in saying that unregulated step therapy policies allow payers to take a one-size-fits-all approach that can restrict physicians from prescribing individualized treatments, according to The Kansas City Star. A coalition of 20 advocacy groups are urging Kansas lawmakers to create legislation that would restrict how insurers can use step therapy and when physicians can override the policies, according to the article. There are 14 states that have enacted similar legislation and many more have proposed bills to restrict step therapy.

A new class-action lawsuit alleges that an insurer misled individuals about the benefits of some Affordable Care Act (ACA) health plans, The Hill reported. The lawsuit claims that enrollees in certain Centene ACA plans had difficulty finding physicians and hospitals that were in the network, according to the article. Customers also said that physicians who were advertised as in-network were actually not covered by the ACA plan.

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