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SB 264

Step-therapy Protocols

2025 Regular Session Introduced by Gayle Harrell

SB 264 would restrict insurance step-therapy protocols requiring patients to try cheaper drugs first, expediting access to prescribed medications but potentially increasing insurance costs.

Died in Appropriations Committee on Health and Human Services
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Bill Summary · SB 264

Legislative bill overview

SB 264 restricts "step-therapy" protocols, which require patients to try cheaper medications before insurers cover more expensive treatments. The bill would limit insurers' ability to deny or delay coverage for prescribed medications based on these sequential treatment requirements, potentially requiring faster access to a patient's drug of choice.

Why is this important

Step-therapy can delay treatment for patients with serious conditions, but it also controls healthcare costs by encouraging use of lower-cost alternatives first. This bill affects the balance between patient access speed and insurance affordability, impacting both individual healthcare experiences and insurance premium structures across Florida.

Potential points of contention

  • Patient access vs. cost control: Restrictions on step-therapy may increase insurance costs and premiums, potentially offsetting individual patient benefits
  • Medical autonomy debate: Disagreement over whether doctors or insurers should make final determinations on medication sequencing and necessity
  • Implementation burden: Unclear what "faster access" mechanisms would cost insurers and whether expedited review processes were adequately funded (bill died in Appropriations Committee)

Compiled from official sources — confirm details with the bill’s official record.

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