Federal RuleAug 21
62
DOL Rewrites Disability Rules for 'Merit-Based Opportunity' Push
RuleLabor DepartmentFederal Contract Compliance Programs OfficeSignificant Wallet
119-s-2903119th CongressWALLET
Safe Step Act
Sponsored By: Senator Murkowski, Lisa [R-AK]
In Committee
Summary
Mandatory exceptions process for medication step therapy in group health plans. This bill would require plans and issuers to let participants or prescribers request clear, prompt, and transparent exceptions and would mandate public reporting to the Secretary of Labor.
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- Families and patients: Patients could get faster access to prescribed non-preferred drugs when doctors request exceptions, with initial decisions in 72 hours and expedited reviews in 24 hours for urgent cases.
- Prescribers and clinicians: Prescribers could submit clinical rationale and medical records on a standard paper or electronic form and request expedited review when delay risks severe harm.
- Group health plans and issuers: Plans would have to keep granted exceptions in effect for at least 1 year and publish process details in plan materials and online.
- Pharmacy benefit managers and administrators: Plans would have to report step therapy requests, approvals, denials, appeals, and related conditions to the Secretary of Labor starting within 3 years and annually after, and contracts could not block access to information needed for those reports.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Easier drug exceptions for employer plans
If enacted, this bill would require employer group health plans that use step therapy to offer a clear, prompt exceptions process. You or your prescriber could ask to skip a required step when prior drugs failed, a delay could cause serious or irreversible harm, there is a contraindication or likely bad reaction, or you are already stable on the requested drug. Plans would decide normal requests within 72 hours and urgent requests within 24 hours. If an exception is approved, the plan would cover the drug for at least one year. The bill would require a standard paper and electronic form, let representatives act for patients, require the Department of Labor to issue rules within six months, require reporting on requests and decisions, and bar contracts that block plans from getting pharmacy data needed for reporting. It would apply to plan years that begin at least six months after enactment.
Sponsors & CoSponsors
Sponsor
Murkowski, Lisa [R-AK]
AK • R
Cosponsors
Sen. Fetterman, John [D-PA]
PA • D
Sponsored 9/24/2026
Sen. Hassan, Margaret Wood [D-NH]
NH • D
Sponsored 9/18/2025
Sen. Marshall, Roger [R-KS]
KS • R
Sponsored 9/18/2025
Sen. Rosen, Jacky [D-NV]
NV • D
Sponsored 9/18/2025
Sen. Padilla, Alex [D-CA]
CA • D
Sponsored 9/18/2025
Sen. Hickenlooper, John W. [D-CO]
CO • D
Sponsored 9/18/2025
Sen. Merkley, Jeff [D-OR]
OR • D
Sponsored 9/18/2025
Sen. Sullivan, Dan [R-AK]
AK • R
Sponsored 9/18/2025
Sen. Warnock, Raphael G. [D-GA]
GA • D
Sponsored 9/18/2025
Sen. Hyde-Smith, Cindy [R-MS]
MS • R
Sponsored 9/18/2025
Sen. Cortez Masto, Catherine [D-NV]
NV • D
Sponsored 9/18/2025
Sen. Moran, Jerry [R-KS]
KS • R
Sponsored 9/18/2025
Sen. Cramer, Kevin [R-ND]
ND • R
Sponsored 9/18/2025
Sen. Kaine, Tim [D-VA]
VA • D
Sponsored 9/18/2025
Sen. Budd, Ted [R-NC]
NC • R
Sponsored 9/18/2025
Sen. Shaheen, Jeanne [D-NH]
NH • D
Sponsored 9/18/2025
Sen. Booker, Cory A. [D-NJ]
NJ • D
Sponsored 9/18/2025
Sen. Wyden, Ron [D-OR]
OR • D
Sponsored 9/18/2025
Sen. Coons, Christopher A. [D-DE]
DE • D
Sponsored 9/18/2025
Sen. Blumenthal, Richard [D-CT]
CT • D
Sponsored 10/1/2025
Sen. Boozman, John [R-AR]
AR • R
Sponsored 10/1/2025
Sen. Gillibrand, Kirsten E. [D-NY]
NY • D
Sponsored 10/1/2025
Sen. Tillis, Thomas [R-NC]
NC • R
Sponsored 10/7/2025
Sen. Heinrich, Martin [D-NM]
NM • D
Sponsored 10/7/2025
Sen. Klobuchar, Amy [D-MN]
MN • D
Sponsored 10/7/2025
Sen. Van Hollen, Chris [D-MD]
MD • D
Sponsored 10/21/2025
Sen. Schiff, Adam B. [D-CA]
CA • D
Sponsored 10/23/2025
Sen. Kelly, Mark [D-AZ]
AZ • D
Sponsored 10/23/2025
Sen. Fischer, Deb [R-NE]
NE • R
Sponsored 10/27/2025
Sen. Peters, Gary C. [D-MI]
MI • D
Sponsored 11/19/2025
Sen. Duckworth, Tammy [D-IL]
IL • D
Sponsored 12/4/2025
Sen. Ossoff, Jon [D-GA]
GA • D
Sponsored 12/9/2025
Sen. Smith, Tina [D-MN]
MN • D
Sponsored 12/16/2025
Sen. Collins, Susan M. [R-ME]
ME • R
Sponsored 2/12/2026
Sen. Gallego, Ruben [D-AZ]
AZ • D
Sponsored 2/24/2026
Sen. Warner, Mark R. [D-VA]
VA • D
Sponsored 2/25/2026
Sen. Welch, Peter [D-VT]
VT • D
Sponsored 3/2/2026
Sen. Whitehouse, Sheldon [D-RI]
RI • D
Sponsored 3/5/2026
Sen. Murray, Patty [D-WA]
WA • D
Sponsored 3/5/2026
Sen. Hirono, Mazie K. [D-HI]
HI • D
Sponsored 3/10/2026
Sen. Kim, Andy [D-NJ]
NJ • D
Sponsored 3/10/2026
Sen. Cantwell, Maria [D-WA]
WA • D
Sponsored 3/17/2026
Sen. Capito, Shelley Moore [R-WV]
WV • R
Sponsored 3/25/2026
Sen. Justice, James C. [R-WV]
WV • R
Sponsored 4/28/2026
Sen. Husted, Jon [R-OH]
OH • R
Sponsored 6/2/2026
Sen. Murphy, Christopher [D-CT]
CT • D
Sponsored 6/9/2026
Sen. Slotkin, Elissa [D-MI]
MI • D
Sponsored 6/15/2026
Sen. Wicker, Roger F. [R-MS]
MS • R
Sponsored 7/28/2026
Sen. Warren, Elizabeth [D-MA]
MA • D
Sponsored 7/28/2026
Sen. Bennet, Michael F. [D-CO]
CO • D
Sponsored 7/28/2026
Sen. King, Angus S., Jr. [I-ME]
ME • I
Sponsored 7/29/2026
Sen. Baldwin, Tammy [D-WI]
WI • D
Sponsored 9/17/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov