While many studies have examined the impact of step-therapy on the quality of care patients receive, few have examined reduced physician autonomy due to step-therapy or provider agreement with proposed exemption processes for step-therapy. This study will focus on understanding the impact of step-therapy on provider perceptions on cost, quality, autonomy, and job satisfaction among providers of rheumatoid arthritis treatments in North Carolina. Research Questions: 1. Do providers believe step-therapy reduces costs by changing the prescribing decisions of providers? 2. Does step-therapy influence providers’ perceived ability to provide quality care? 3. Does step-therapy reduce provider autonomy and thus reduce provider job satisfaction? 4. Do state policy makers have the ability to reduce the impacts providers face due to step-therapy?