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 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. Release of New Avalere Study Today, the Partnership also released a new report, with data analysis commissioned from Avalere Health, to determine how the protected classes policy is actually being implemented. The results were not positive for patients. Indeed, according to the Avalere analysis, Part D plans are increasingly leveraging formularies and utilization management tools to limit access to medications for Medicare beneficiaries across drugs in the protected classes. For example, in 2019, the most recent year for which data is available, plans covered just 54% of drugs across the protected classes — a decrease of nearly 20% since 2016. And for those drugs that were covered, nearly two-thirds of all medications in the six protected classes were placed in a non-preferred or specialty category, which increase patient out-of-pocket costs in an effort to drive those patients towards other medications. “As Medicare drug plans increasingly erect barriers for patients who rely on medications covered under the six protected classes, this updated study suggests that, if anything, Medicare’s protected classes policy isn’t being implemented as it should,” said Chuck Ingoglia, President and CEO of the National Council for Behavioral Health, who serves as Executive Director of the Partnership. “The Administration ought to be strengthening this vital protection — not contemplating its repeal.” Background The Trump Administration’s formulary flexibility proposal is contrary to bipartisan congressional consensus, as expressed numerous times in recent years, and undermines long-standing and congressionally directed protections that guarantee access to life-saving drugs for patients with the most severe health conditions. Indeed, Congress has repeatedly expressed strong bipartisan support for the protected classes policy and has chosen to strengthen, rather than weaken it, over time. In a Senate colloquy just before the enactment of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), Senators repeatedly emphasized the role of protections, including the protected classes, available to beneficiaries who need “exactly the right medicine for them.”[1] Congress reaffirmed the importance of the original protected classes in Section 3307 the Affordable Care Act (ACA), which codified in law the six protected classes and categories by name, and expanded coverage to include “all” drugs within these six classes. Additionally, every Member of the Senate Finance Committee opposed CMS’ 2014 proposed rescission of protected-class protections, echoed in a separate letter from 50 Members of the House Energy and Commerce and the Ways and Means Committees. More recently, in 2019, the Trump Administration attempted to roll back these important patient protections and were again rebuffed with significant opposition from Congress. Ultimately, the policy suggesting changes to the six protected classes was withdrawn. [1] 149 Cong. Rec. S5887-88.
45 Comments
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7/24/2022 07:14:53 pm
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Soing Shade
6/16/2023 04:14:43 pm
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Soing Shade
6/16/2023 04:14:56 pm
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4/13/2023 02:18:54 pm
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Soing Shade
6/16/2023 04:15:07 pm
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5/14/2023 02:03:48 pm
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6/16/2023 04:15:16 pm
Hi viewers online, I’m here to share my testimony about how I was helped to get my husband back. I was a cheat and my husband caught me several times. I tried fixing myself and each time I ended up cheating over and over again. I guess I didn’t realize what he meant to me until he had left me alone. I began to find a way to get him back but nothing seemed to work out perfectly until I came across an article about Dr Peter who helped a lot of people globally to get their relationships back. I made contact with him and he assured me that my husband will come back to me within 48 hours with his powerful magic for the materials needed for the work. Surprisingly, my husband came back home after 2 days saying that he still loves me and I swore never to cheat on him anymore. All thanks to Dr Peter. You can have a chat with him on his Emaildrpeterspellcater21@gmail.com
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5/31/2023 10:22:14 pm
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6/16/2023 04:15:46 pm
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6/16/2023 04:16:01 pm
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Soing Shade
6/16/2023 04:14:26 pm
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6/18/2023 09:17:46 am
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8/2/2023 06:30:08 am
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8/31/2023 07:24:40 pm
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9/1/2023 11:45:18 am
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9/3/2023 12:36:09 pm
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John Goodman
9/4/2023 07:06:17 am
I was in total dismay when I lost my entire savings investing in cryptocurrency, I was contacted online by a lady through email pretending to be an account manager of a bank, who told me I could make double my savings through cryptocurrency investment, I never imagined it would be a scam and I was going to lose everything. It went on for weeks until I realized that I have been scammed. All hope was lost, I was devastated and broke, fortunately for me, I came across an article on my local bulletin about Elite Wizard Bitcoin Recovery, I contacted them and provided all the information regarding my case, I was amazed at how quickly they recovered my cryptocurrency funds and was able to trace down those scammers. I’m truly grateful for their service and I recommend them to everyone who needs to recover their funds urge you to contact them if you have lost your bitcoin USDT or ETH through bitcoin investment
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Hey guys, my name is Qin from Hong Kong . I was defrauded of $210,000.00USD in a binary investment trading scam, and I wasn't even aware of it until a month later. When they refused to respond to my emails and texts, I realized something was amiss. The website and the services I utilized were so sincere, and everything felt legitimate. I was prepared to concede defeat since I didn't know what to do or how to proceed until I talked about it with a friend who suggested that I contact George Wizard Recovery Home to help me recover my invested money. Although I wasn't really convinced, I had to get my money back and had no choice but to get in touch with George Wizard Recovery Home, which I did. They worked really hard to recover all of my money and were incredibly helpful. Their aid in finding my missing money has truly impressed me. While George Wizard Recovery Home Group is not a medical professional, they have helped save my life. To anyone who has lost money in a currency scam, I'd heartily suggest them. Get in touch with them via: georgewizardrecoveryhome(@)gmail.com Whatsapp : +1 (908) 768-4663
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RECOVER YOUR STOLEN BITCOIN OR MONEY LOST TO SCAMMERS WITH A LEGIT RECOVERY EXPERT: Have you ever been a victim of online scam? or have you lost your money to fake hackers online? I implore you to contact this trustworthy hacker and recovery expert by name George Wizard . I was scammed by some group of persons posing as binary options and bitcoin investors, I lost a sum of $98,000 and 2BTC from my bitcoin wallet to these fake brokers.It took a while before I realized they were scams and this really hurt me. Then an in-law of mine heard about it and recommended me to a specialist with the address georgewizardrecoveryhome@gmail.com. He helped me recover my lost bitcoin in less than 48hrs and the scammers were caught and made to pay for what they did to me. If you have lost any amount to online scammers and you’re seeking to recover loss from wallet hackers, fake hackers, online dating scams, btc wallet hack, recovery of lost funds from fake binary investors or any online scam. Reach out to info@georgewizardrecoveryhome.com or what’sapp +1 (908) 768-4663, with the best service to help you, and you will be so glad you did so, best believe recovery expert referral.
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John Goodman
9/20/2023 10:17:13 am
I was in total dismay when I lost my entire savings investing in cryptocurrency, I was contacted online by a lady through email pretending to be an account manager of a bank, who told me I could make double my savings through cryptocurrency investment, I never imagined it would be a scam and I was going to lose everything. It went on for weeks until I realized that I have been scammed. All hope was lost, I was devastated and broke, fortunately for me, I came across an article on my local bulletin about Elite Wizard Bitcoin Recovery, I contacted them and provided all the information regarding my case, I was amazed at how quickly they recovered my cryptocurrency funds and was able to trace down those scammers. I’m truly grateful for their service and I recommend them to everyone who needs to recover their funds urge you to contact them if you have lost your bitcoin USDT or ETH through bitcoin investment
Reply
9/23/2023 10:14:32 am
Here are some reasons I appreciate about Wizard Web Recovery:
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