Partnership for Part D Access
  • Home
  • About Us
    • Who We Are
    • Patient Communities
    • Our Leadership
  • The Issue
    • Six Protected Classes
    • History
  • Resources
  • Newsroom
  • Stakeholder Voices
  • Contact Us
  • Home
  • About Us
    • Who We Are
    • Patient Communities
    • Our Leadership
  • The Issue
    • Six Protected Classes
    • History
  • Resources
  • Newsroom
  • Stakeholder Voices
  • Contact Us

Newsroom​ 

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

3/8/2021

13 Comments

 
Picture
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.
Our senior care facilities do everything in their power to protect residents from COVID-19, and it's important that we continue to prioritize the health and safety of our most vulnerable population.
​
In Washington, D.C., our elected officials must act to increase health care access for America’s elderly, ensuring they receive the medicine they need to thrive. Unfortunately, rather than protect our seniors, the Center for Medicare and Medicaid Innovation has chosen to further restrict access to high-quality care.

On Jan. 15, under the Trump administration, CMMI launched the Payment Modernization Model — a proposed set of new administrative rules governing Medicare Part D prescription drug plans.

These changes, CMMI claimed, would save Medicare money. But to achieve those cost savings, CMMI took aim at a vital aspect of Part D — a safeguard essential to Medicare recipients’ well-being — Medicare Part D’s six protected classes.

Under the current Medicare system, the six protected classes form a critical buffer against health complications. Essentially, the Part D program grants six separate types of medications — anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals and immunosuppressants — a special status within Part D health care plans.

The rule ensures that each formulary must cover “all or almost all” medications within each class. In this way, patients and their doctors aren’t required to conform to a “one-size-fits-all” treatment plan. They can tailor the medications to fit the needs of their particular condition, while resting assured that their Medicare Part D plan will cover the drugs that they need to stay healthy.

But under CMMI’s Payment Modernization Model, that would change.

CMMI’s new model would require that each Part D plan cover just one medication per protected drug class, effectively stripping formularies of treatment options.

And while this may, on the surface, appear to succeed at cutting costs for the government, it would do so at the expense of seniors’ health care access. Under the proposal, patients would undoubtedly find that their personalized treatment plans are no longer available in their Part D plans.

The drugs they rely upon to manage their health would cease to be covered. As a result, CMMI would force far too many seniors to utilize medications that don’t fully address their specific health care needs, resulting in less-effective, riskier treatments.

The utilization of less effective treatments may lead to a number of seniors requiring a higher level of care. This in turn would cost taxpayers additional expenses, offsetting any potential savings from restricting medications.

Such an outcome would have catastrophic consequences for patients, particularly seniors living in assisted living facilities. By weakening Medicare Part D’s six protected classes, the Payment Modernization Model practically guarantees that many of these individuals will experience health complications. Given that seniors are already at an elevated risk of COVID-19, compounding the threat further by reducing health care access is reckless and does not put patients first.

The Biden administration must reconsider this CMMI initiative, revoking the changes proposed under the Payment Modernization Model. Indiana’s seniors already have enough to worry about due to the pandemic; there’s no need to make the situation worse.

Dan Kenyon is executive director of the Indiana Assisted Living Association.
13 Comments
Marie Johnson link
3/3/2022 12:58:41 pm

The drugs they rely upon to manage their health would cease to be covered. I truly appreciate your great post!

Reply
Michael Herring link
3/4/2022 02:18:54 pm

The proposal, patients would undoubtedly find that their personalized treatment plans are no longer available in their Part D plans. Thank you for taking the time to write a great post!

Reply
Shon Huggins link
3/12/2022 10:53:41 am

They can tailor the medications to fit the needs of their particular condition, Thank you, amazing post!

Reply
Joseph Shelton link
3/14/2022 01:25:59 pm

While resting assured that their Medicare Part D plan will cover the drugs that they need to stay healthy. Thank you for sharing your great post!

Reply
Elizabeth Thompson link
3/14/2022 02:58:51 pm

The Payment Modernization Model practically guarantees that many of these individuals will experience health complications. I’m so thankful for your helpful post!

Reply
Michael Bales link
4/21/2022 12:00:15 pm

The surface, appear to succeed at cutting costs for the government, it would do so at the expense of seniors’ health care access. Thank you, amazing post!

Reply
Robert Dickerman link
4/22/2022 10:39:25 am

Such an outcome would have catastrophic consequences for patients, particularly seniors living in assisted living facilities. I’m so thankful for your helpful post!

Reply
Christopher Riley link
4/23/2022 09:03:25 am

The utilization of less effective treatments may lead to a number of seniors requiring a higher level of care. Thank you for sharing your great post!

Reply
Patrick Herrick link
4/27/2022 01:10:41 pm

This in turn would cost taxpayers additional expenses, offsetting any potential savings from restricting medications. I truly appreciate your great post!

Reply
Buster Alexander link
6/17/2022 11:42:42 pm

The drugs they rely upon to manage their health would cease to be covered. As a result, CMMI would force far too many seniors to utilize medications that don’t fully address their specific health care needs, Thank you for the beautiful post!

Reply
Brian Blais link
6/21/2022 08:30:38 am

They can tailor the medications to fit the needs of their particular condition, while resting assured that their Medicare Part D plan will cover the drugs that they need to stay healthy. I’m so thankful for your helpful post!

Reply
Jred Hatty
7/24/2022 07:13:40 pm

I TESTED POSITIVE FOR HSV-2 A FEW MONTHS AGO.
At first, Yes, I was devastated thinking I have an incurable STD for life. After doing hours of research I quickly realized genital herpes is a filthy parasite that just likes to hide in your body. Yes, There’s no “medical cure” but that doesn’t mean your body can’t get rid of it. I literally flush it out of my system with the help of Doctor Azuka, A natural herbal medicine which I ordered after doing some research. And now I’m HSV-2 negative, I never believed it until my doctor finally gave me the test results and behold I was HSV-2 free. I’m so glad that I found you, Doctor Azuka. Thanks so much for your goodness I’m grateful. You can also get your help from him through his
Email } dr.azukasolutionhome@gmail.com
WhatsApp } +2349166175418

Reply
David Gibson link
8/25/2022 12:36:01 pm

Under the proposal, patients would undoubtedly find that their personalized treatment plans are no longer available in their Part D plans. Thank you, amazing post!

Reply



Leave a Reply.

    Author

    Write something about yourself. No need to be fancy, just an overview.

    Archives

    September 2022
    November 2021
    March 2021
    February 2021
    January 2021
    November 2020
    January 2020
    July 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    April 2018
    March 2018
    September 2017
    May 2017
    April 2017
    November 2016
    July 2016

    Categories

    All

    RSS Feed

Learn more

About Us
Patient Communities
​Issues
​Background

What's New?

​Newsroom
Resources
​

Contact

Contact Us
© COPYRIGHT 2018. ALL RIGHTS RESERVED.