Advanced, metastatic cancer; delete repealer on prohibition against health plans requiring step therapy before covering certain drugs to treat.

No step therapy for metastatic cancer drugs

Beginning July 1, 2026, health plans cannot make you try or fail another drug before covering an FDA-approved drug for advanced, metastatic cancer or its associated conditions. The drug must align with best medical practice and be backed by peer‑reviewed evidence. If your plan still uses step therapy, your doctor can ask for a fast override; the plan must grant it when the preferred drug hasn’t worked, is likely not to work for you, or may cause harm. Any step‑therapy stage cannot last more than 30 days once your doctor finds it isn’t effective; the plan can add up to 7 more days only if your doctor shows more time is needed. When rules conflict, the cancer‑specific protections control.