Insurance: health insurers; coverage for step therapy; modify. Amends sec. 3406t of 1956 PA 218 (MCL 500.3406t).

This bill requires Michigan health insurers and health maintenance organizations to offer a program that synchronizes multiple maintenance prescription drugs for patients with chronic long-term conditions, provided the patient, physician, and pharmacist agree it is in the patient's best interest. The law mandates that if a step therapy protocol is used to restrict drug coverage, the criteria for these protocols must be based on high-quality clinical practice guidelines developed by an unbiased, multidisciplinary panel that includes public review opportunities. Additionally, the bill establishes specific conditions under which a step therapy exception must be granted quickly, such as when a drug is contraindicated, ineffective, or causes harm, and it ensures that all relevant clinical review criteria are transparently available to patients and healthcare providers.