This post originally appeared in the Daily Memphian on February 27, 2019.
As we trudge through February’s chill, rain and the ever-present potholes, I can’t help but look forward to the start of baseball season and those summer days having a cold beer while cheering my favorite team. Baseball is unpredictable. A stolen base, a wild pitch or a ninth-inning home run can change the course of the game. Epilepsy, like baseball, is unpredictable. Heat, humidity and exposure to the sun can trigger a seizure, and that’s what happened to a friend of mine who accompanied me to a game last season. The unpredictable nature of the disorder often makes epilepsy difficult to control and manage.
This post originally appeared in The Virginia Gazette on February 19, 2019.
At his pre-election campaign rallies, President Trump promised to protect Medicare. But now, his administration quietly embraces drastic changes that could choke off seniors' access to lifesaving treatments. Consider the administration's new guidance for Medicare Advantage, which enables about 20 million Medicare beneficiaries to obtain subsidized health plans from private insurers. The guidance, which took effect in January, allows insurers to force beneficiaries to try older, low-cost medications before they can access more advanced, expensive drugs.
This post originally appeared in Inside Health Policy on February 12, 2019.
HHS may stop the insurance industry practice of making seniors fail on drugs that have already failed for them when switching to a new Medicare drug plan, HHS Secretary Alex Azar told the American Medical Association Tuesday (Feb. 12).The practice is known as step therapy, though patient advocates often call it fail first. Azar learned of that application of the practice in meetings with patients and doctors who are urging against a separate HHS proposal to use step therapy more broadly in six protected drug classes.
This post originally appeared in Modern Healthcare on February 12, 2019.
HHS Secretary Alex Azar said the agency is exploring cracking down on a practice insurance plans use to make a patient start over on step therapy if they switch plans. Azar's comments before the American Medical Association's Advocacy Conference in Washington on Tuesday comes as the agency is proposing allowing Medicare Advantage plans to apply step therapy and prior authorization to drugs sold in Medicare Part B and Part D. The practice has opposition from some patient groups who fear that the tools hinder patient access.
The Partnership for Part D Access applauded HHS Secretary Alex Azar for his remarks in a speech today before the American Medical Association (AMA) in which he acknowledged the dangers inherent in requiring step therapy for patients who are already stabilized on an effective regimen of medications. Interestingly, his remarks seemed to run counter to his agency’s current proposal to weaken Medicare’s successful “six protected classes” policy. Given today’s statement, the Partnership urges the Secretary to abandon the administration’s proposal, which countless stakeholders would agree is “penny-wise and pound-foolish.”
This post originally appeared in Roll Call on February 5, 2019.
President Donald Trump’s plan to eliminate HIV transmission in the United States by 2030, which he announced Tuesday night, would be an ambitious goal that would require his administration to reverse course on a number of policies that potentially hinder access to HIV/AIDS care. “Together, we will defeat AIDS in America,” Trump said in his State of the Union address. He said that his budget will “ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.”
This op-ed originally appeared in The Hill on February 4, 2019.
When then-President Lyndon Johnson signed Medicare into law in the summer of 1965, he declared, “No longer will older Americans be denied the healing miracle of modern medicine.”Johnson’s pledge was as prophetic as it was audacious: Medicare fundamentally transformed health care, giving seniors unprecedented access to the medicine and services they need to live longer, healthier lives.That promise now hangs in the balance. The Trump administration is pushing policies that threaten to undermine Medicare coverage for many of America’s most vulnerable seniors and people with disabilities. The worst of these misguided proposals could kill people. This might sound hyperbolic, but it’s not.
This post originally appeared in the Washington Examiner on January 31, 2019. .
Outside groups prepare to fight Trump drug pricing proposal. Outside groups involved with fighting HIV, epilepsy, and serious mental illness are prepared to battle the Trump administration on a plan to change Medicare Part D, the portion of the program that covers prescription drugs. The administration has proposed making changes to what are known as the “six protected classes” of drugs, which allow certain patients with serious health conditions to receive any drug that their doctor determines is best to treat them.
This post originally appeared in Politico Pro on January 29, 2019.
Industry and patient groups alike are pushing back on a CMS proposal to give Medicare Part D and Medicare Advantage plans power to limit coverage of “protected class” medicines in a bid to lower government spending. The deadline to submit comment on CMS’s proposal, Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses, was Jan. 25 and hundreds rolled in. While the proposed rule lays out a number of strategies, the top item would give plans broader negotiating tools — including step therapy and prior authorization — for anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals and immunosuppressants.
This post initially appeared in The Buffalo News on January 22, 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. By law, Part D drug plans are required to cover all drugs in six “protected classes” of medicines. This requirement ensures that seniors and people with disabilities have widespread access to drugs used to treat cancer, depression, HIV and more.