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Patient Advocates Applaud Biden Administration for Maintaining Medicare's Six Protected Classes Policy

3/16/2021

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Contact: Shea McCarthy 
smccarthy@thornrun.com
(202) 285-3866
FOR IMMEDIATE RELEASE
March 16, 2021
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​Washington D.C. — The Partnership for Part D Access, a broad-based coalition of health care stakeholders including diverse patient advocacy organizations that represent patients who benefit from treatments covered under each of Medicare’s “six protected classes,” commended the Centers for Medicare and Medicaid Services (CMS) for rejecting a proposal that would have substantially weakened Medicare’s six protected classes policy.


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Lawmakers on Mental Health, HIV Caucuses Urge Biden to Rescind Trump Changes to Part D Demo

3/11/2021

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Members of the Congressional Mental Health and HIV Caucuses recently urged the Biden administration to revoke a final-hour request by the last administration to weaken Medicare protected class drug coverage. The lawmakers implored the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) to reconsider the changes to the Medicare Part D Payment Modernization (PDM) model, noting the new model doesn’t fairly take into account the public health implications for patients that utilize drugs under the six protected classes.  

The letter advocates for the Acting HHS Secretary and Acting CMS Administrator to pull back new allowances under the PDM model that would allow participating plans to weaken coverage requirements to one drug per class, as well as limit coverage of medication in all six protected classes by CY 2023. The lawmakers note that Pat D plans are already equipped with the necessary tools to manage spending and encourage the use of generics when possible for the six protected classes.

“These proposed changes fail to consider the unique needs of patients who need the treatment that is best for their condition, or patients who must try different treatments before finding the right treatment for their needs,” the letter explains. “we do not believe these formulary flexibility changes to the model would result in significant cost savings but will instead push access to essential medications out of reach for vulnerable patients.”

The bipartisan group of 67 members joined “significant opposition from Congress, patient groups, providers, and other stakeholders” to the potential changes to protections for the six protected classes.
 
The letter in its entirety can be read here. 

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Op-ed: In Throes of Pandemic, Hoosiers in Assisted Living May Face This New Challenge

3/8/2021

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This post originally appeared in the Indianapolis Star on March 4, 2021

The COVID-19 pandemic has been extremely challenging for Indiana’s senior population. Having overseen our state’s assisted living and independent living facilities throughout the pandemic, we find the situation that thousands of senior Hoosiers are facing is heartbreaking and frightening.

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Former Rep. Patrick Kennedy: Trump, Biden Medicare Moves Need Fixing

3/8/2021

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This post originally appeared in The Boston Herald on March 4, 2021.

On Donald Trump’s last full day in office, his administration announced a policy change that would make it easier for insurers to deny medicine to vulnerable Medicare beneficiaries. Those most affected will include people with mental health disorders, a group that already faces major roadblocks — including stigma and discrimination — when pursuing treatment.​

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Patient Groups Urge Becerra to Maintain Medicare’s Protected Class Benefit

3/1/2021

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This post originally appeared in the Washington Post's "Health 202" newsletter on February 26. 2021. 

More than 100 patient advocacy organizations sent a letter to Biden’s health and human services secretary nominee, Xavier Becerra, urging him to protect a Medicare policy that ensures coverage of a wide range of drugs used to treat complex medical conditions

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Advocacy Groups Urge Becerra Reject Trump's Policy Eliminating Protected Classes

3/1/2021

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This post originally appeared in CQ Healthbeat on February 26, 2021. 

Patient advocacy groups are pushing Biden's nominee to lead Health and Human Services to reject a last-minute Trump administration policy demonstration that weakened two pillars of Medicare Part D’s patient protections. One change allows plans to skirt Medicare's six protected classes, and the other change eliminates the requirement that insurers cover at least two drugs in all classes.

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Patient Groups Warn Against Weakening Protected Classes Drugs

3/1/2021

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This post originally appeared in Inside Health Policy on February 26. 2021

Nearly 140 patient groups are urging the Biden administration to block an 11th-hour Trump-era policy change to let drug plans ignore Medicare protections of some of the most vulnerable patients, and the head of the HIV+Hepatitis Policy Institute warned of litigation if the administration doesn’t block the policy. 

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