Senate Bill (SB) 99 passed the Arkansas State House on Monday in a unanimous 96-0 vote, sending a bill which will reform step therapy practices in Arkansas to Gov. Asa Hutchinson for his signature.

Step therapy, or “fail-first” policies, are a tactic used by health insurance companies to require patients to attempt to use cheaper versions of medications before considering more expensive “name-brand” options. While step therapy can be beneficial, namely to keep patient and insurance company costs down, they can also cause patients to delay starting medications they desperately need, step therapy reform advocate Dr. Michael Saitta of the Arkansas Rheumatology Association said in an interview with the Log Cabin last month. Saitta and the state rheumatology association worked with SB99’s sponsor, State Sen. Cecile Bledsoe of Rogers, to craft the bill to reform “fail-first” protocols in the state and join a host of other U.S. states, including Texas and Oklahoma, in having step therapy laws.

The reforms outlined in SB99 require health insurance providers to base decisions regarding step therapy on medical data and allow patients a “fair, transparent and independent process for requesting a step therapy protocol exception,” the bill’s text reads.

After a lengthy multi-week amendment process, SB99 passed the state senate in a unanimous bipartisan vote with 35 “yeas.” Once the governor signs the bill into law, SB99 will go into effect beginning in January of 2022.

Staff Writer Kolton Rutherford can be reached at

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