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Safe Step Act

S. 2903 Sen. Lisa Murkowski (R-AK) In committee
Bill text PDF
  1. Introduced Sep 18
  2. Committee Sep 18
  3. Passed Senate Next
  4. Passed House Not yet
  5. To President Not yet
  6. Law Not yet
Where it stands
In committee, Sep 18, 2025Next: Senate vote
222d ago Mar 19, 2026: Committee on Health, Education, Labor, and Pensions. Hearings held.
Final votes
No roll callsNo recorded vote on this bill yet
Lobbying
5companies, 13 filings
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12trades in the last 90 days
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Summary

This bill amends the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers that use medication step therapy protocols to provide a clear, prompt, and transparent exceptions process for participants, beneficiaries, or their prescribing health care providers to request an exception to such protocols.

Sec. 2, Required exceptions process for medication step therapy protocols: The bill adds a new section to ERISA requiring plans or issuers to implement an exceptions process. Exceptions must be granted if: (1) required treatments were ineffective; (2) delay would cause severe or irreversible harm; (3) treatments are contraindicated or likely to cause harm; (4) treatments prevent reasonable functional ability; (5) the participant is stable on a previously approved drug; or (6) other circumstances determined by the Secretary. The process must include a standard form, allow paper and electronic submission, not require unnecessary information, and allow a representative to act on behalf of the participant. Information about the process must be in plan materials and on websites. Plans or issuers must respond to standard requests within 72 hours, and to expedited requests (where life or health is at risk) within 24 hours. If an exception is granted, coverage for the requested drug must last at least one year. The term "medication step therapy protocol" is defined as a protocol requiring a participant to try an alternative preferred drug before coverage of a non-preferred drug. The section applies regardless of how the protocol is described. Plans and issuers must report to the Secretary annually on the number of exception requests, approvals, denials, appeals, and other data, starting 3 years after enactment. The Secretary must submit a summary report to Congress annually. The amendment applies to plan years beginning at least 6 months after enactment, and the Secretary must issue final regulations within 6 months.

Summary of the bill text as introduced in Senate (Sep 18, 2025), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.

Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 27, 2026.