A new study from the Partnership for Part D Access confirms that the Medicare Part D protected classes policy is an essential pillar of protection for beneficiaries with complex health conditions. Yet, the research also highlights that Medicare prescription drug plans (PDPs) are increasingly limiting access to medications — even for patients with complex, chronic conditions. The study, performed by Avalere Health, a leading strategic advisory company, provides new insights into the various steps Medicare Part D plans are taking to manage utilization of medications covered under Medicare’s six protected classes policy. The protected classes policy is designed to ensure that Medicare beneficiaries with some of the most serious health conditions — cancer, HIV, epilepsy, mental illness, and those at risk of organ rejection, among others — have access to the full range of medicines recommended by their physician.
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
Under a dangerous last-minute proposal from the Trump administration, millions of patients may soon lose access to vital medications. Specifically, a proposed demonstration from the Center for Medicare and Medicaid Innovation (CMMI) would allow health plans to sharply scale back their coverage of drugs in Medicare’s six “protected classes” — a policy change that would have devastating consequences for patients. This hasty, deeply misguided program would severely jeopardize Medicare beneficiary access to medications used to manage complex conditions such as cancer, mental illness, HIV-AIDS, epilepsy, Parkinson’s, and organ transplantation.
Two leading Medicare beneficiary advocacy groups have joined the chorus of stakeholders calling upon the President Joe Biden to take immediate action to rescind the Trump administration’s last-minute attempt to weaken coverage requirements for drugs within the six protected classes policy.
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