BILL NUMBER:  AB 369
  VETOED	DATE: 09/30/2012




To the Members of the California State Assembly:

I am returning Assembly Bill 369 without my signature.

This bill would prohibit a health plan or insurer from requiring a
patient to try and "fail" more than two medications before allowing a
patient to have the pain medication prescribed by his or her doctor.


While I sympathize with the author's good intentions, I am not
convinced that this bill strikes the right balance between physician
discretion and health plan or insurer oversight. A doctor's judgment
and a health plan's clinical protocols both have a role in ensuring
the prudent prescribing of pain medications. Independent medical
reviews are available to resolve differences in clinical judgment
when they occur, even on an expedited basis.

If current law does not suffice ? and I am not certain that it doesn'
t, any limitations on the practice of "step-therapy" should better
reflect a health plan or insurer's legitimate role in determining the
allowable steps.

Sincerely,



Edmund G. Brown Jr.