Patient Access for a Healthy Texas is focused on state and federal issues impacting patients’ access to prescription medicines and health care. The issues we highlight here are part of our current focus on reducing or eliminating barriers and hurdles to prescription medicines and health care. Doing so, benefits patients, health care providers and taxpayers, who help fund the Texas Medicaid program.
The Texas Medicaid Vendor Drug Program currently ensures patients’ access to life-saving drug therapies and specific medicines. By limiting step therapy and similar insurance-mandated practices, the program protects patients who cannot risk taking medications that their doctors did not prescribe. Importantly, the current program treats all patients equally.
We continue to educate and defend against policies that limit patient access, including:
“Fail First” and Step Therapy
“Fail first” and step therapy are processes by which insurance companies, looking for their own cost-savings, are aggressively working to impose rules requiring a patient to be moved from the best drugs that doctors prescribe to treat their patients’ conditions to medicines that could be less effective or ineffective. Often times these policies mean that Texans living in rural, urban or different parts of the state would be treated differently in their access to prescription medicines.