The 2019–2020 legislative cycle in the states holds real hope and opportunity for critical reforms to protect rheumatology practices and patients. It is important to note that because of the state legislative process, bill passage almost always comes later in the legislative session. Although the rheumatology community has not yet seen many official wins, early movement and discussions are promising signs for the remainder of the legislative session.
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Utilization Management Reform
Utilization management reform efforts are seeing early movement in state legislatures. We are actively tracking 42 utilization management bills, and a few step therapy reform efforts seem to be the most viable at the moment.
Two states with an early promise of success are Virginia and Georgia. H.B. 2126 in Virginia has already passed out of the House of Delegates and out of the Senate Finance Committee. A potential problem for this bill: The Senate Finance Committee inserted language that would require funding in the budget for the bill to become effective. The bill sponsor, Rep. Steve Davis (R), is working to secure that funding, but this could become a poison pill for the legislation if funding is not secured.
Additionally, Georgia’s step therapy bill (H.B. 63) passed out of the House again, where it passed unanimously last year. The political dynamics in the Senate have changed, and there is renewed hope that the bill could pass the Senate this session.