Contact: Jakara Eason
November 29, 2021
Today, 36 leading health advocacy organizations sent a letter to Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) underscoring the value to patients of Medicare’s 6 protected classes policy.
The letter was signed by leading health advocacy organizations, including the National Council for Mental Wellbeing, the Cancer Support Community, Epilepsy Foundation, HIV+Hepatits Policy Institute, the American Kidney Fund, Depression and Bipolar Support Alliance, The Kennedy Forum, and Mental Health America. The letter states,
“This policy has been a vital protection for patients and restricting access to these therapies would have major, life-threatening consequences for patients and increase the likelihood of costly hospitalizations and emergency room visits…”
The letter was sent in response to a request for information sent by Senate Finance Committee leadership on September 22, 2021.
For more information, or to download the letter in its entirety, please click here.
Patient Advocates Applaud Biden Administration for Maintaining Medicare's Six Protected Classes Policy
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.
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.
Over 130 Patient Groups Urge Secretary-designee Becerra to Maintain Key Medicare Protection for Patients
Partnership releases study showing that the Six Protected Classes policy needs strengthening, not elimination
Multi-Group Letter Sent to Becerra
The Partnership for Part D Access sent a letter today cosigned by 138 individual patient advocacy organizations to Department of Health and Human Services Secretary-designee the Honorable Xavier Becerra, highlighting the importance of Medicare’s six protected classes policy and urging the Biden administration to reject a late Trump administration proposal to eliminate the benefit.
The Partnership for Part D Access sent a letter today cosigned by 138 individual patient advocacy organizations to Department of Health and Human Services Secretary-designee the Honorable Xavier Becerra, highlighting the importance of Medicare’s six protected classes policy and urging the Biden administration to reject a late Trump administration proposal to eliminate the benefit
“The protected classes policy has been a cornerstone of Part D’s success: helping to ensure that Part D formularies serve the needs of all Medicare beneficiaries, including the most vulnerable patients with the greatest need for drug coverage,” the letter states. “Accordingly, we implore you to reverse [the Trump administration] policy immediately.”
On January 19, 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced the opportunity for new “formulary flexibilities” for Medicare Part D plans that participate in its Part D Payment Modernization (PDM) Model. Under the proposal, participating plans can choose to limit the drugs they cover, including denying patient access to medications used to manage complex conditions such as cancer, mental illness, HIV/AIDS, epilepsy, Parkinson’s, and organ transplantation.
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