By Andy Marso, February 10, 2016
The Kansas Senate approved a bill 23-16 this week to allow the state to require Medicaid recipients to try cheaper drugs to treat their ailments before stepping up to more expensive alternatives. Senators added an amendment to track the savings to the state.
Proponents of “step therapy” like Sen. Jim Denning, a Republican from Overland Park, said every other state already has the requirement and Gov. Sam Brownback is counting on the $10.6 million in projected savings to help balance the budget.
“The governor did bank those savings,” Denning said. “It’s baked into the budget.”
Sen. Vicki Schmidt, a Republican from Topeka, said she was skeptical that level of savings would materialize and introduced the amendment to require the Kansas Department of Health and Environment to submit an annual savings report to the Legislature.
It passed 27-8.
Schmidt, a pharmacist, unsuccessfully tried to tack on four other amendments that would have carved out certain drug classes and medical conditions from the step therapy requirements.
Drawing on her experience working with pharmacy benefits managers from private insurance companies, she said her colleagues don’t understand the frustrations the bill will cause for medical doctors and other prescribers.
“There is not an M.D. in our crowd here today,” Schmidt said.
Denning said the bill was necessary to curb ever-rising Medicaid costs. But he also said the state’s Drug Utilization Review Board would only enact step therapy requirements that improve patient outcomes.
“It’s in our best interest to get them on the right drug at the right time and keep them out of the hospital,” Denning said.
Sen. Mary Pilcher-Cook, a Republican from Shawnee who chairs the Senate Public Health and Welfare Committee, said she also expected step therapy to be a boon to Medicaid recipients’ health.
“This is about better patient care,” Pilcher-Cook said. “This is about science.”
Sen. Laura Kelly, a Democrat from Topeka, said she suspected the bill was about money rather than better patient care.
“We are interfering — inserting ourselves between the patient and the physician,” Kelly said.
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