Brain Health
Brain Health Colorado supports HB1130
HB1130 aims to limit step therapy practices in Colorado for patients suffering from Serious Mental Illnesses (SMIs). The bill will ensure that SMI patients be required to try only one prescription drug as a part of the step therapy process before receiving insurance coverage for the drug originally prescribed by their provider.
Learn more about the bill and how it will benefit Colorado’s SMI population here
When a patient carries a physical health condition, they will usually schedule a visit with their doctor who will diagnose the condition and prescribe the best medication in a timely manner. Unfortunately, this is not always the case when a patient visits their doctor to treat their mental health.
Before even scheduling an appointment, those struggling with their mental health have to overcome the societal stigma against having and treating a mental illness – a stigma which is more present in communities of color.
When they finally take that step to addressing their mental health, these patients may be forced to receive both prior authorization and undergo a step therapy process by their insurance provider to receive proper treatment.
What is Step Therapy?
Step therapy is a process where a patient must be prescribed several low-cost, generic versions of medication before their insurance will cover the potentially more expensive medication that a patient’s doctor recommends. This means that it can be months before a patient is prescribed the medication that could best treat their mental health. To make matters worse, patients could suffer through the side effects of each potentially ineffective medication they sample. The insurance procedure is further extended when patients need to go through prior authorization with their insurance company.
What is Prior Authorization?
Prior authorization is a process where physicians need to obtain approval from their patient’s health insurance plan before they can prescribe medication. This further drags out the time period from when a patient first talks about their concerns with their doctor, to when they are prescribed the treatment that will treat their condition best. Brain Health Colorado is looking to shorten this time period, to ensure that those struggling with a mental health issue get prescribed the best medication for them – not the one their insurance plan wants them to take.