Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB836 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	LRB-1507/1
2	2	JPC:cdc
3	3	2023 - 2024 LEGISLATURE
4	4	2023 ASSEMBLY BILL 836
5	5	December 22, 2023 - Introduced by Representatives SUBECK, JOERS, C. ANDERSON,
6	6	J. ANDERSON, ANDRACA, CONLEY, CONSIDINE, EMERSON, JACOBSON, MADISON,
7	7	MURSAU, ORTIZ-VELEZ, RATCLIFF and STUBBS, cosponsored by Senators
8	8	HESSELBEIN, L. JOHNSON, AGARD, CARPENTER, SPREITZER, TAYLOR and WIRCH.
9	9	Referred to Committee on Health, Aging and Long-Term Care.
10	10	*AUTHORS SUBJECT TO CHANGE*
11	11	AN ACT to renumber 632.866 (1) (a); and to create 632.866 (1) (ag), 632.866 (1)
12	12	(cm) and 632.866 (2m) of the statutes; relating to: prohibiting step therapy
13	13	protocols for certain cancer drugs.
14	14	Analysis by the Legislative Reference Bureau
15	15	This bill prohibits an insurer, pharmacy benefit manager, or utilization review
16	16	organization from requiring a step therapy protocol for a drug that is prescribed for
17	17	metastatic cancer or a cancer-associated condition and the use of the drug is
18	18	approved by the federal Food and Drug Administration, consistent with best
19	19	practices for the treatment of metastatic cancer or the cancer-associated condition,
20	20	and supported by peer-reviewed publications that are based on evidence-based
21	21	research. A step therapy protocol, as defined in current law, establishes a specific
22	22	sequence in which medically appropriate prescription drugs are covered by a policy
23	23	or plan. Current law requires insurers, pharmacy benefit managers, and utilization
24	24	review organizations to use clinical review criteria for establishing a step therapy
25	25	protocol that are based on clinical practice guidelines that meet certain specific
26	26	criteria and to provide access to a process to request an exception to the step therapy
27	27	protocol.
28	28	The people of the state of Wisconsin, represented in senate and assembly, do
29	29	enact as follows:
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31	31	2
32	32	3 - 2 -2023 - 2024 Legislature LRB-1507/1
33	33	JPC:cdc
34	34	SECTION 1 ASSEMBLY BILL 836
35	35	SECTION 1. 632.866 (1) (a) of the statutes is renumbered 632.866 (1) (ar).
36	36	SECTION 2. 632.866 (1) (ag) of the statutes is created to read:
37	37	632.866 (1) (ag) “Cancer-associated condition” means any symptom or side
38	38	effect that is associated with metastatic cancer or the treatment of metastatic cancer
39	39	and that, in the judgment of a health care provider, further jeopardizes the health
40	40	of a patient if left untreated.
41	41	SECTION 3. 632.866 (1) (cm) of the statutes is created to read:
42	42	632.866 (1) (cm) “Metastatic cancer” means cancer that has spread from the
43	43	primary or original site of the cancer to nearby tissues, lymph nodes, or other areas
44	44	or parts of the body.
45	45	SECTION 4. 632.866 (2m) of the statutes is created to read:
46	46	632.866 (2m) STEP THERAPY PROTOCOL PROHIBITED. An insurer, pharmacy
47	47	benefit manager, or utilization review organization may not require a step therapy
48	48	protocol for a drug that is prescribed for metastatic cancer or a cancer-associated
49	49	condition and the use of the drug is all of the following:
50	50	(a) Approved by the federal food and drug administration.
51	51	(b) Consistent with best practices for the treatment of metastatic cancer or the
52	52	cancer-associated condition.
53	53	(c) Supported by peer-reviewed publications that are based on evidence-based
54	54	research.
55	55	(END)
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