SDPA is among 75 patient and provider advocacy groups that signed a letter submitted to key members of Congress requesting support of timely access to medical treatments as part of their plans for mental health packages and to address provider burnout.
Specifically, the patient and provider groups ask that such legislation include step therapy reform in ERISA health plans, as outlined in the Safe Step Act (HR 2163/S 464).
As with other chronic illnesses, medication is an important treatment option for people with mental illnesses as well as those suffering from substance abuse. However, insurance-mandated step therapy can reduce medication adherence, increase serious adverse events, and increase costs.
Given the abysmal health outcomes among patients subject to medically inappropriate step therapy, unsurprisingly utilization management exacerbates provider burnout which is already a national problem due to the COVID-19 pandemic. According to the American Medical Association, 88% of physicians describe the burden of prior authorization (PA) high or extremely high, 40% report having dedicated staff to manage PAs, and physicians report spending two business days per week on PAs. The American College of Gastroenterology (ACG) recently reported that PA is “harming patients and overwhelming practices.”
The letter was sent May 24, 2022, to U.S. Senator Richard Burr (R-N.C.), ranking member, Senate Committee on Health, Education, Labor & Pensions; U.S. Senator Patty Murray (D-WA), chair, Senate Committee on Health, Education, Labor & Pensions; U.S. Rep. Robert Scott (D-VA), chair, House Education & Labor Committee; and U.S. Rep. Virginia Foxx (R-N.C.), ranking member, House Education & Labor Committee.
The full text of the letter may be accessed here.
