American Pain Foundation. Dedicated to the elimination of the
undertreatment of pain.
ACTION ALERT:
California Fail First Bill Goes for Vote on June 30, 2010
California residents, we are calling on you to write your senators
today!This bill, which prohibits “fail first”
practices by insurers, has been steadily moving through the California
Assembly and will go for a vote in the Health Committee on Wednesday,
June 30. This bill addresses the troubling practice of
“fail first” or step therapy. Step therapy or
“fail first” therapy occurs when an insurer requires that
other therapies must be tried and must fail before people with pain
can obtain the medicine originally prescribed by their health care
provider. Currently, some individuals are required to try up to five
different medications or treatments before receiving the medication
recommended by their provider. “Fail first” places
an undue burden on people with pain, who often must suffer while their
insurance companies override decisions of qualified health care
providers. This legislation would limit this practice.
Please write your state senators to urge them to SUPPORT this
important legislation. Click here to TAKE ACTION!
http://action.painfoundation.org/site/R?i=BJhyyftxSx6xGtpfjQmPvw..
* To read APF’s position statement on step therapy, please
click here.
http://action.painfoundation.org/site/R?i=w7KZZ90_TjU9ZF5Gl-KW3A..
* To read the full text of this bill, please click here.
http://action.painfoundation.org/site/R?i=SFuuUPIgwTmfhjFAm0AOww..
NOTE: This alert is targeted to Health Committee members, our
system will only let you send a message if you are in their
district. If you are not (our system will tell you if you are
not) and would like to submit a letter, please address it to the chair
of the Health Committee, State Senator Elaine Alquist. A copy of the
letter is below, just cut and paste the content into your word
processing program in order to create and send your letter.
State Senator Elaine Alquist
Chair, Senate Health Committee
State Capitol, Room 2191
Sacramento, CA 95814
The American Pain Foundation thanks the organization, For Grace, for
their efforts in sponsoring and supporting this important legislation.
Sincerely,
American Pain Foundation
To Connect and Support our Efforts:
* Keep up with us on Facebook and
http://action.painfoundation.org/site/R?i=y8b_8GDSxZMl6TGhc4kNaA..
Twitter.
http://action.painfoundation.org/site/R?i=zKq0z-ZKnWjJa8dm4QWmJQ..
* Visit the APF Action Network site to learn what advocates are
doing to build the movement for better pain management and get
involved!
http://action.painfoundation.org/site/R?i=8fwjvT_DnxDQnjnMmuy9qg..
* Visit the Exit Wounds site to learn more about our Military and
Veterans living with pain.
http://action.painfoundation.org/site/R?i=bg_KxHnQFEUzSEXWB2ekRQ..
* Join PainAid, our online support community.
http://action.painfoundation.org/site/R?i=Z8rVTjsfgLM-y-TylSljsw..
Letter to State Senator Elaine Alquist:
I am writing you today to request that you support AB 1826 with the
proposed amendments. This legislation is critical to ensuring that
medical decisions regarding prescriptions and treatments for pain are
made by the direct patient care providers (physicians, nurse
practitioners and physician assistants) and not insurance
administrators.
AB 1826 will help medical professionals do what they do best practice
health care. Step therapy or “fail first” therapy occurs when an
insurer requires that other therapies must be tried and must fail
before people with pain can obtain the medicine originally prescribed
by their health care provider. Currently, some individuals are
required to try up to five different medications or treatments before
receiving the appropriate medication. We believe it is unethical and
unreasonable to ask anyone with pain to suffer while the insurance
company overrides the decision of the medical professional. This bill
will assure that insurance companies cover the medicines that
providers prescribe without interference.
The Federal Department of Health and Human Services (DHHS), Centers
for Medicare and Medicaid Services (CMS) issued a 2010 Call Letter to
limit step therapy in health plans for Medicare patients.
These regulations:
* Prohibit health plans from requiring a person to fail first on
an off-label medication (not FDA-approved) before providing
access to a FDA-approved medication for that condition.
* Limit step therapy to two trials and failures of formulary
alternatives before providing access to the prescribed medicine.
[Insert your personal story here]
Improper or inappropriate care invariably leads to more persistent
illness and complications, which is far more expensive in the long
run. True health care cost containment can be realized with bills like
AB 1826, by restoring a much needed balance in the provision of
appropriate health care. Please give this bill your support.
Sincerely,
[name]
[address]
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