Patient Access to Specialty Tier Drugs Act - HB 875

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Help us get specialty drugs access for all Georgians!


This week the Patient Access to Specialty Tier Drugs Act House Bill 875 was dropped on the floor of the Georgia House.


Sponsored by Rep. Lee Hawkins and Rep. Sharon Cooper, this bill will help limit out of pocket costs for lifesaving specialty drugs and promote a broader range of reporting by insurance plans. 


Specifically, this bill requires insurers to:

·      Ensure the out-of-pocket expense for a covered specialty drug for an individual prescription does not exceed $200.00 per 30 day supply ($1,000.00 per insured or $2,000.00 per insured family per plan year)

·      Provide certain information (i.e. definitions of drug tiers, prescription drug formularies, drug costs, prior authorization requirements, and other information) in plain language

·      Establish a dedicated pharmacy consumer service phone line

·      Establish an exception approval process to allow physicians to request a specialty drug not included on the issuer’s formulary

·      Ensure the prior authorization approvals for specialty drugs are not changed for the duration of a plan year.


If enacted, this bill would go into effect beginning January 1, 2017.


Review the bill at:…/…/Display/20152016/HB/875


ARxC and the Specialty Tiers Coalition of Georgia are seeking stories from Georgians about their experience accessing their specialty drugs. Please send stories through our website at or directly to Dorothy Leone-Glasser, Chair of the Specialty Tiers Coalition of Georgia, at  


Our website is being updated with more information and directions for the public’s engagement. Please go to to find out how you can be engaged. From here you can send a letter of support for HB 875 to your legislator; access samples of social media posts for Facebook, Twitter, and other social media channels; and access other resources (i.e. Patient Stories, background information about the Specialty Tiers Coalition of Georgia, and other information about this legislation).


Please help us take action to ensure Georgians with serious chronic conditions can access the specialty drugs they need to thrive.