On August 13, 2019, Dr. Ralph McKibbin, a gastroenterologist who practices out of Altoona, PA, authored an op-ed in support of a nonmedical switching bill that is currently being considered by the Pennsylvania legislature. In this piece, Dr. McKibbin elaborates on how nonmedical switching can harm patients and how the practice often interferes with managing conditions that are easily treatable with the right medication. In many instances, disputes with insurance companies delay patient care, which causes patients’ conditions to progress and often results in unnecessary visits to the emergency room. Dr. McKibbin emphasizes that doctors and patients work collaboratively to decide on an appropriate treatment plan, but nonmedical switching makes that process increasingly difficult.
The nonmedical switching legislation, HB 853, would prohibit health plans from reducing benefits in the middle of the plan year if a beneficiary has already received them. This would prevent health plans from using “bait-and-switch” tactics, where they offer coverage to consumers, only to reduce the scope of that coverage in the middle of the plan year. This often occurs with prescription medications, which forces patients to switch to alternative options. As Dr. McKibbin asserts in his op-ed, forcing patients to switch treatments can cause them to experience negative health outcomes, which increases costs across the entire health care system.