Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Texas Rheumatologists Push for Passage of Step Therapy Reforms

Gretchen Henkel  |  June 15, 2017

On May 25, with Gov. Greg Abbott’s signing of Senate Bill 680, Texas became the fourth state this year to increase protection for patients subject to insurers’ step therapy protocols. The State of Texas Association of Rheumatologists (STAR) joined with 35 other professional societies and patient advocacy organizations in urging passage of S.B. 680. The passage of the bill entailed a lengthy process, and enjoyed “widespread bipartisan support,” according to Rep. Greg J. Bonnen, MD (R, District 24), which includes part of Galveston County. Rep. Bonnen authored House Bill 1464, the tandem bill in the House to Sen. Kelly Hancock’s Senate bill.

Rep. Greg J. Bonnen, MD (R, District 24).

According to Rodolfo “Rudy” Molina, MD, president of STAR and a rheumatologist in private practice with Arthritis Associates PA of San Antonio, the state association received notification of the pending legislation in early February. Simone Nichols-Segers of the National Multiple Sclerosis Society, and Hayley McCloud, the ACR state government representative, urged STAR to officially join the consortium of organizations supporting the bill. Dr. Molina and Sharad Lakhanpal, MD, FACR, FACP, ACR president and clinical professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, contacted their own district representatives to inform them of their support for the bill and urged association members to do the same.

Sharad Lakhanpal, MBBS, MD

Sharad Lakhanpal, MD, FACR, FACP, ACR president.

Cost Vs. Patient Benefit
S.B. 680 and H.B. 1464 were drafted to address concerns about insurers’ overuse of step therapy (also called fail-first) protocols, explains Dr. Bonnen—namely that protocols were being driven more by commercial concerns than by scientific evidence. “Patients were encountering scenarios where they’d been on a medication and had been stable for a long period of time—in some instances for years—and then their insurer would change the protocol and potentially force them to change their medicine.”

Dr. Lakhanpal, like many rheumatologists, is all too familiar with the complications and dangers of fail-first therapy. “We know that denying treatment for a patient with inflammatory arthritis for four to six months can cause irreversible joint damage. We have to always think, ‘What is best for the patient?’”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

As insurers have increased their use of step therapy protocols to control the cost of expensive drugs, more advocacy organizations have raised concerns about the ethics of the practice. The ACR and other professional medical societies have urged reform so that authorization of medications is based on clinical criteria.

Page: 1 2 | Single Page
Share: 

Filed under:Legislation & AdvocacyProfessional Topics Tagged with:H.B. 1464S.B. 680State of Texas Association of Rheumatologists (STAR)step therapystep therapy reform legislation

Related Articles

    Rheumatologist Rudy Molina, MD, Pursues Passion for Paleontology

    December 17, 2015

    When Rodolfo “Rudy” Molina, MD, was 8 years old, a college recruiter visited his home. Unbeknownst to his parents, their son, now a rheumatologist at Arthritis Associates in San Antonio, Texas, had entered several of his drawings in a competition intended for high school students. The recruiter, unaware of the young artist’s age, was definitely…

    Speak Out Rheum: To Prescribe Is Humane (Unless You’re In Texas)

    November 7, 2022

    You are a rheumatologist in Texas. You are very well trained. Your mentors included some of the leaders in rheumatology, and you are respected by your colleagues and your patients. You know the devastation of untreated rheumatoid arthritis and lupus. A young woman with recent onset of systemic lupus erythematosus is your new patient. You…

    A Glimpse into the Life of New ACR President, Dr. Sharad Lakhanpal

    November 30, 2016

    Born and raised in Lucknow, India, Sharad Lakhanpal, MBBS, MD, vividly remembers his father’s stories of traveling to the U.S. As a young boy, he grew intrigued, imagined living here and knew that someday he would narrate his own adventures about this country. As president of the ACR and a practicing rheumatologist at Rheumatology Associates…

    Welcome New ACR and ARHP Leaders

    December 1, 2012

    The American College of Rheumatology (ACR) welcomes the newest members of the ACR board of directors and the Association of Rheumatology Health Professionals (ARHP) executive committee

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences