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Rep. Lipps Tackles Health Policy in His First Term

Ohio House Passes Stroke and Step Therapy Bills
December 14, 2018
P. Scott Lipps News

COLUMBUS—State Representative Scott Lipps (R-Franklin) today announced that the Ohio House has concurred on House Bill 464, a bill that will establish stroke protocols and recognize stroke centers. The main goal of this legislation is to save lives and limit disability caused by strokes.

Stroke is the fifth leading cause of death in America, and the leading cause of adult disability. In 2013, 5,690 Ohioans died as a result of a stroke. The cost to Ohio is estimated to be $2.5 billion each year, and is expected to almost double by the year 2020. Studies show significant fiscal savings if more stroke patients were treated immediately. These staggering statistics have already led 21 states to pass similar legislation.

Additionally, this bill will require the recognized list of hospitals or centers to be posted on the Ohio Department of Health (ODH) website and provided to all EMS agencies across the state. All EMS authorities statewide shall establish pre-hospital care protocols related to the assessment, treatment, and transport of stroke patients by licensed emergency medical services providers. It will also require any Ohio hospital or center to seek or change their accreditation for stroke care and require ODH to survey hospitals regarding stroke care. There would be no fiscal impact and certification is voluntary.

“The goal of this legislation is to save lives and limit disability caused by strokes. From my personal experience, I am honored to have worked on such an important piece of legislation and I thank my joint-sponsor Rep. Antonio (D-Lakewood) and the American Heart/American Stroke Association for all their hard work on this bill,” said Lipps.

The Ohio House also passed step-therapy reforms yesterday during House session. On behalf of over 60 patient advocate organizations, Rep. Lipps was able to play an integral role in championing the legislation alongside bipartisan sponsors of the legislation State Senators Peggy Lehner (R-Kettering) and Charleta Tavares (D-Columbus), and State Representatives Terry Johnson (R-McDermott) and Nickie Antonio (D-Lakewood).

Step therapy is a common practice by health insurers to require that a patient first fail on a lower tier drug before stepping them up to the medication that their physician prescribed. The legislation passed by the House gives patients three opportunities to be granted a step therapy exemption:

1. If the required drug is contraindicated for that specific patient, pursuant to the drug's FDA prescribing information
2. If the patient has tried the required prescription drug while under their current, or a previous, health benefit plan, or another FDA approved AB-rated prescription drug, and such prescription drug was discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event
3. If the patient is stable on a prescription drug selected by their health care provider for the medical condition under consideration, regardless of whether or not the drug was prescribed when the patient was covered under the current or a previous health benefit plan

These new step therapy reforms will help create a balanced system that provides Ohioans with greater access to the medications that they need, while also preserving the cost-saving mechanism that is in place.

The step-therapy reform legislation, Senate Bill 265, will return to the Senate for concurrence on a House amendment, and House Bill 464 now heads to the Governor’s desk for his consideration.