This post originally appeared in Inside Sources on April 8, 2019.
When Congress passed Medicare Part D in 2003, it took steps to protect patients in the midst of a health crisis. When time is of the essence and the stakes are life-and-death, that is not when Washington bureaucrats or health insurers should be trying to eke out cost savings. But now unelected officials at the Centers for Medicare and Medicaid Services (CMS) are moving to strip those safeguards from law.
Leading stakeholders within the HIV/AIDS community recently penned op-eds outlining the detrimental effects that the Trump administration's proposed drug pricing rule would have on patients. The authors astutely note that a "one-size-fits-all" approach is the wrong solution given the complexity of the disease as well as the individual needs of HIV patients. Stakeholders also emphasized that reliance on step therapy and prior authorization would create additional barriers to access for lifesaving treatments.
This post originally appeared in the Memorial Examiner on March 28 2019.
Recently, the Centers for Medicare and Medicaid Services (CMS) proposed a troubling regulation that would weaken Medicare Part D, the federal program that helps 45 million American seniors and people with disabilities afford prescription drugs. Part D is unique among government programs. The federal government allows people to purchase coverage from private insurers. The government subsidizes these plans but otherwise lets Medicare beneficiaries choose the coverage that’s best for them.
This post originally appeared in Public News Service on March 29, 2019.
From coast to coast, people who rely on Medicare Part D could be left without their medications if a proposal by the Centers for Medicare and Medicaid Services is adopted. Medicare Part D is a federal program that subsidizes prescription drug costs for 45 million seniors and people with disabilities. The feds say they want to amend what's called the "six protected classes rule," and allow insurers to exclude many drugs from Part D plans. Fatima Hyacinthe, trainer and engagement director with the Black AIDS Institute, says people who rely on those medications already report discriminatory practices by insurance companies, despite the rules.
This post originally appeared on MySanAntonio.com on March 22, 2019.
One threat stems from the Trump administration, which has suggested weakening the so-called protected classes provision in Medicare “Part D.” Medicare’s Part D drug benefit has enabled seniors to purchase subsidized prescription coverage from private insurers. Part D regulations require every plan to cover all medications in six protected classes of therapies, including anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals, and immunosuppressants. This protection ensures that older adults who battle cancer, HIV/AIDS, depression, and other serious diseases have a full range of treatment options.
This post originally appeared in the Montgomery Herald on March 21, 2019.
Since leaving the U.S. House of Representatives in 2011, I've dedicated my professional life to fighting for full implementation and enforcement of the Mental Health Parity and Addiction Equity Act of 2008 – a law I had the honor of authoring with Congressional colleagues in true bipartisan spirit.The law requires most insurers to cover illnesses of the brain, such as depression or addiction, no more restrictively than illnesses of the body, such as diabetes or cancer. MHPAEA was written to ensure equitable prescription drug coverage for mental health conditions. Equitable drug coverage means that we are able to work with our doctors to try different prescription medications until we find what works. The process can take months, sometimes years. Having more choices means having more opportunities to get well.
This post originally appeared in the Richmond Register on March 25, 2019.
The Trump administration is poised to undermine seniors' access to lifesaving medications. It recently proposed a rule that would weaken patient protections within Medicare's "Part D" prescription drug benefit. Part D drug plans are required to cover all drugs in six "protected classes" of medicines. This ensures that seniors have widespread access to drugs used to treat cancer, depression, HIV, and more.
This post originally appeared in Inside Health Policy on March 14, 2019.
A bipartisan group of more than 70 House lawmakers wants CMS to withdraw a proposal to weaken coverage protections in six classes of drugs, according to a March 13 letter to HHS Secretary Alex Azar. Patient and provider groups have been highly critical of the Trump administration’s proposal to let insurers use step therapy and prior authorization for drugs in those drug classes, and now CMS is feeling the pressure from Congress. The letter focuses on HIV drugs, which is the only class of drugs among the six that treats an infectious disease, but the lawmakers make clear they don’t want to weaken protections in any of the classes.
This post originally appeared in STAT News' "DC Diagnosis" Newsletter on Tuesday, March 19 2019.
HHS Secretary Alex Azar trudged up to Capitol Hill three separate times last week, and he got some tough but expected questions about Obamacare, the agency’s family separation policy, and myriad other hot-button health policy issues. But one line of questioning was striking — and surprisingly bipartisan: It concerned the agency’s idea of allowing private Medicare plans to not cover certain drugs that treat conditions like depression and HIV — drugs known as the so-called protected classes.
This post originally appeared in Targeted Oncology on March 15, 2019.
"The healthcare community is still awaiting a response from the Centers for Medicare & Medicaid Services (CMS) to the opposition of the agency’s proposal to substantially revise the Medicare Part D protected drug classes. Protection of the 6 drug classes within the Part D prescription drug plan, which include antineoplastics such as chemotherapies, was instituted in 2006 to ensure that commercial health plan sponsors of the newly launched Medicare Part D program would make these drugs available to patients."