Senator Wiener Introduces SB 70 — the Medication Access Act — to Protect Patients From Insurance Company Harmful Changes To Their Medication 

January 10, 2023

FOR IMMEDIATE RELEASE

January 10, 2023

 

SACRAMENTO - Senator Scott Wiener (D-San Francisco) introduced Senate Bill 70, the Medication Access Act. SB 70 improves access to medication by limiting the circumstances in which a health plans can change a patient’s medication for financial, rather than medical reasons. The bill builds on existing protections against the practice, expanding them to include dosage and medication form (intravenous, oral, etc.). The bill builds on the success of last year’s SB 853, which passed the Senate in a bipartisan, unanimous vote.

 

“Insurance companies should not be able to disrupt a patient’s care, risking severe pain and even death, to save money,” said Senator Wiener. “As someone living with a chronic health condition, I know how sensitive patients can be to even minor changes in the dosage or form in which they receive medication. This bill will ensure patients retain access to their prescribed medication and that life-saving coverage continues. I look forward to building on last year’s strong effort and delivering this vital protection to Californians in need.”

 

Changing a patient’s medication to something other than what their doctor prescribed is an insurance company practice sometimes known as “non-medical switching.”  Under the Knox Keene Health Care Service plan act of 1975, non-medical switching is prohibited in California. However, the law does not prohibit switching to a generic drug band, off-label medications or a change in dose level or dosage form. SB 70 aims to close these loopholes.

 

The impact of these seemingly minor changes in medication can be serious for thousands of Californians living with chronic illnesses. For example, patients living with conditions like inflammatory bowel disease (IBD) and multiple sclerosis (MS) undergo a painful and time intensive process to find effective treatment, often experimenting with multiple medications and dosages. Their conditions are prone to unexpected flare ups that necessitate changes in dosage. Sometimes they must take a drug orally rather than intravenously to avoid interfering with another treatment, like chemotherapy. When insurance companies disrupt this delicate balance, they cause unnecessary suffering and can put patients at risk of life-threatening complications.

 

SB 70 is sponsored by the Crohn’s & Colitis Foundation.


“Patients with inflammatory bowel disease have a limited number of treatment options,” said Michael Osso, President & CEO Crohn’s & Colitis Foundation. “When a medication is not covered at the therapeutic dose, treatment can become ineffective leading to severe, and sometimes irreversible, negative health outcomes in both adult and pediatric patients.  Having access to the right medication, at the right time, and at the best dosage for that individual’s disease is essential.  We appreciate Senator Wiener’s efforts to ensure that patients have access to the necessary medication at a dose that is most appropriate for their needs.”