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Ohio Non-medical Switching Legislation Update

posted: February 27, 2019

OAR President Dr. Stephanie Ott and OAR government affairs traveled to Columbus to meet with State Representative Scott Lipps to talk about Ohio non-medical switching legislation. Rep. Lipps has agreed to sponsor a bill in Ohio for the 2019 legislative session. The bill is currently being drafted. OAR will continue to work on non-medical switching reform with Ohio legislators and keep membership updated on the developments.

Several other states have formally introduced non-medical switching legislation this year, which include: Florida, Indiana, Iowa, Massachusetts, Maryland, Minnesota, New Mexico, New York, Oregon, and Texas.

A patient study was conducted by the Indiana Stable Patient Protection Coalition (ISPPC) recently on non-medical switching. Of the patient respondents surveyed, (68.9 percent) reported that they were victims of non-medical switching, and (69.2 percent) of those patients did not have the opportunity to reject or decline the switch. The study revealed that when patients did try to revert to their original prescription, changes in insurance coverage were found to be so dramatic that approximately three-fourths (74.1 percent) reported that the primary therapy prescribed to them became suddenly and significantly more expensive to obtain.

On January 1, 2019, Illinois’ non-medical switching law took effect. Public Act 100-1052 provides that commercial health insurance plans cannot remove a drug from its formulary unless the plan notifies the patient at least 60 days before the coverage change occurs. When a health plan notifies the prescribing provider about a midyear formulary change, they are required to include a one-page form or instructions to access an online portal where the provider can easily request that the health plan continues providing coverage because the drug is medically necessary.