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Contents

  • Step Therapy Update
  • Budget Media
  • Brown County Drug Court

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Legislative Website

Learn more about what I am working on here in Madison to improve the lives of my constituents!

HOPE Agenda

Stay up-to-date and informed on our progress to combat the opioid epidemic in our state.

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Step Therapy Heads to Governor's Desk

You may remember that over the last few months I have been working on a bill to reform our state's step therapy protocols process.

When a physician prescribes a particular drug treatment for a patient, the patient’s insurance company may require them to try a less expensive treatment, or series of treatments, before they can have access to the drug originally prescribed by their physician. The patient is not able to try the second treatment until the first one is proven to “fail.” This protocol is known as “step therapy” and is deployed by insurance companies as they strive to control costs while maintaining high-quality care.

This week thousands of patients across Wisconsin are one step closer to receiving the right care at the right time. When Senator Darling and I first introduced this bill, we were amazed at the outpouring of support and personal stories that we received. It reminded us that the work we do here in Madison has a direct impact on the families of Wisconsin, and how important expeditiously moving this legislation is.

At the public hearing, people from all over Wisconsin came to tell us their story, and how this bill will positively impact their lives. After working with various health insurance groups, patient advocates, and healthcare providers, we arrived at a bill that keeps the spirit, integrity, and patient protections of the original bill, while still ensuring the health plans have the ability to meaningfully utilize step therapy protocols in order to keep costs down.

This bill creates a few common-sense exceptions to step therapy protocols and puts in place a timeline so patients can get answers more efficiently.

  1. The prescription drug required under the step therapy protocol is contraindicated or, due to a documented adverse event with a previous use or a documented medical condition, including a comorbid condition
  2. The prescription drug required under the step therapy protocol is expected to be ineffective.
  3. The patient has tried the prescription drug required under the step therapy protocol, or another prescription drug in the same pharmacologic class or with the same mechanism of action, under the policy or plan or a previous policy or plan,
  4. The patient is stable on a prescription drug selected by his or her health care provider for the medical condition under consideration while covered under the policy or plan or a previous policy or plan.

Under this bill,  decisions on exceptions would need to be granted within 3 business days and in emergency circumstances, 1 business day.

I would like to thank Speaker Vos for shepherding this bill through the Assembly in a timely manner. I now call on Governor Tony Evers to sign this bipartisan bill into law as soon as possible, so patients can get the care they need and deserve more efficiently.

Click here to watch the press conference I participated in on this bill.

 

Click here for a story on the bill heading to Governor Ever's desk.

 

If you have any questions or comments, please contact my office.

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Budget Media

Last week the Joint Committee on Finance completed its work on the state budget. Beginning next week, both the Senate and the Assembly will be taking up the budget before it heads to the desk of Governor Evers.

I believe that this Wisconsin budget makes crucial investments where it's needed most, while at the same time continuing our trend of responsible budgeting. 

Over the next few days, I will be speaking to media around the state telling the people of Wisconsin why I believe it would be a mistake for Governor Evers to veto this budget.

Last week, I joined Wisconsin Public Television on their program "Here and Now". You can watch that here.

Tonight, at 5 pm, Fox 11 WLUK will be running an interview with me regarding the budget. 

This Sunday, I will be on "Capital City Sunday" on WKOW 27 in Madison. It airs at 9 am this Sunday, you can watch it here then.

I will also be on WFRV "Newsmaker Sunday" to talk about the budget process, you can catch it here.

If you have any questions or comments on the budget, please don't hesitate to call my office!

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Brown County Drug Court

Today I join the Brown County Drug Court Program in celebrating their 10th year of service. I have been a strong proponent of Drug Courts around Wisconsin, their effectiveness speaks for itself.

The National Institute of Justice’s Multisite Adult Drug Court Evaluation (MADCE) found that: Drug court participants reported less drug use (56 percent versus 76 percent) and were less likely to test positive for drug use (29 percent versus 46 percent) than the comparison probationers. Participants also reported less criminal activity (40 percent versus 53 percent) and had fewer rearrests (52 percent versus 62 percent, but not statistically significant difference) than the comparison probationers.

Additional MADCE research found that drug courts produce an estimated $1.50 in benefits for every dollar in costs.

Drug Court is a special court that hears selected cases involving substance-dependent offenders. Drug Court programs are rigorous, requiring intensive supervision by the Drug Court Agent and also frequent appearances before the judge that are weekly, bi-weekly or monthly, depending upon the phase they are in.

They also are subject to frequent, random urinalysis testing and a long-term regimen of treatment and recovery services. Drug Court meets every week and a report of each participant's progress is prepared and given to the Drug Court Team prior to each hearing.

I would like to thank the Brown County Drug Court for their hard work and passion on this issue!

 |State Capitol | Post Office Box 8953 | Madison, Wisconsin 53708 (608) 266-2344 | Toll Free: (888) 534-0089 | Fax: (608) 282-3689 |Rep.Nygren@legis.wi.gov |