US SB2903

Requires group health plans and insurers using medication step therapy protocols to establish a clear exceptions process allowing patients or prescribers to request coverage for non-preferred drugs without first trying preferred alternatives

Mandates exception approval when required step therapy drugs have been ineffective, would cause treatment delays with severe consequences, are contraindicated, would harm functional ability, or when the patient is already stable on the requested medication

Sets response deadlines of 72 hours for standard exception requests and 24 hours for urgent cases involving serious health risks or severe pain

Guarantees coverage for at least one year once a step therapy exception is granted to a participant or beneficiary

Requires annual reporting to the Secretary of Labor on exception requests, approvals, denials, and appeals, with the Secretary submitting public reports to Congress starting 3 years after enactment