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Aimed Monthly, Volume 1, Issue 11

Welcome to Volume 1, Issue 11 of Aimed Monthly! We’re quickly approaching the holiday season, but Aimed Alliance is just as busy as ever. In this issue we’re pleased to share with you our new brochure for employers and HR professionals that serves as a resource during the benefit selection process, a series of videos from the Exocrine Pancreatic Insufficiency Coalition (EPIC), our comment to congressional leaders regarding the Lower Drug Costs Now Act of 2019, and a webinar that we’ll be hosting next month on the burden of cardiovascular disease in the workplace. Explore this and more below!

Highlights

A New Resource for HR Professionals
On October 23, 2019, Aimed Alliance and the National Organization of Rheumatology Managers jointly published a brochure for employers and HR professionals titled “Open Enrollment: Selecting Benefits for Your Employees to Protect Their Health.” This educational resource is intended to assist employers and HR professionals during the benefits selection process and to provide them with information about health plan policies that can impact their employees’ health. You can view the brochure here.
EPIC Video Series
The Exocrine Pancreatic Insufficiency Coalition (EPIC) recently produced videos that featured coalition members discussing exocrine pancreatic insufficiency (EPI) and how it impacts their lives. These inspiring stories portray the resilience of patients who are living with this condition and how they are able to successfully manage their health. You can view these videos on the coalition’s website here.
Supporting AMA Resolutions 
On November 7, 2019, Aimed Alliance issued a letter to the American Medical Association (AMA) House of Delegates, which voiced our support for Resolution 205 and Resolution 815. Both of these resolutions were amended and adopted by the AMA during the 2019 House of Delegates Interim Meeting. Resolution 205 commits the AMA to developing model legislation on copay accumulators, similar to the law that was recently enacted in Virginia, while Resolution 815 commits the AMA to expanding the organization’s advocacy for step therapy protections from Medicare Advantage to all types of health plans. Additionally, Resolution 815 commits the AMA to supporting state and federal legislation that would allow for clinician-initiated exceptions to step therapy protocols. You can review our letter to the AMA here.
 
The Short Term, Limited Duration Plan Landscape
Following the Trump Administration’s executive action last year to adjust federal regulations to expand the availability of short-term, limited duration health insurance plans, some states have taken action to conform state law to the new federal regulations, while others have passed laws that restrict the availability of these types of plans. This month, we updated the maps on our website to include information about states that have enacted laws on short-term health plans, which includes an overview of the states that have enacted these laws as well as details about how the laws impact the availability of short-term, limited duration plans. You can review this map here.
Addressing Health Care Costs 
On November 8, 2019, Aimed Alliance submitted a comment letter to congressional leaders regarding the Lower Health Care Costs Now Act of 2019, a proposal moving through the U.S. House of Representatives that aims to address the rising costs of prescription drugs. We support the legislation's proposal to cap out-of-pocket costs for Medicare Part D at $2,000. This provision is intended to fix the Part D coverage gap that could cause beneficiaries to face a large spike in their out-of-pocket costs in 2020. However, Aimed Alliance opposes the legislation's proposal to increase the reimbursement rate for biosimilar products from Average Sales Price (ASP) + 6 percent to ASP + 8 percent. Aimed Alliance highly supports the adoption of biosimiliars because they are safe and effective treatment options that can increase competition and drive down drug costs. However, this proposal could cause Medicare beneficiaries to pay more out-of-pocket for biosimilar products than they would for biologic products.

Events

  • Webinar - Benefits for Those with Cardiovascular Disease
    • On December 10, 2019, Aimed Alliance will be jointly hosting a webinar with the Alliance for Patient Access (AfPA), the Cardiovascular Disease Working Group, and the Partnership to Advance Cardiovascular Health (PACH), titled “Providing Quality Benefits for Employees with Cardiovascular Disease and Other Chronic Conditions.” The webinar will be held at 1:00-2:00pm ET and will feature a discussion of the economic impact of cardiovascular disease in the workplace, the negative consequences of receiving improper treatment, and tips for preventing discrimination, reducing stigma, and offering comprehensive health coverage. Click here to learn more and register.

Where We've Been

  • FDA EDMAC
    • On November 14, 2019, Aimed Alliance Policy Advisor Taylor Kelly presented before the U.S. Food and Drug Administration’s (FDA) Endocrinologic and Metabolic Drugs Advisory Committee (EDMAC) regarding the pending approval of a new therapy to reduce the risk of cardiovascular disease. Ms. Kelly discussed the importance of approving the product because it would reduce the likelihood of patients being required to overcome utilization management requirements to access the medication off-label and advocated for the committee to approve the product to provide patients with additional options to manage their risk of cardiovascular disease.
  • NFWL Annual Conference
    • On November 20, 2019, Stacey L. Worthy and Shruti Kulkarni, who both serve as counsel to Aimed Alliance, presented at the National Foundation of Women Legislators Annual Conference in San Antonio, Texas. Their presentation, titled “Improving Access to Health Care: 8 Timely Topics in 30 Minutes,” included a discussion about protecting access to health coverage, skinny health insurance plans, step therapy, prior authorization, nonmedical switching, copay accumulators, bad-drug advertisements, and surprise medical bills.

In Case You Missed It

  • Copay Accumulator Webinar
    • Earlier this month, Aimed Alliance hosted a webinar on copay accumulators, titled “Copay Accumulators: Striking a Balance Between Promoting a Healthy Workforce & Managing Costs.” This webinar featured a discussion of recent legislative and regulatory developments that affect these programs, the impacts that these policies can have on employees, and recommendations for best practices for employers who are interested in implementing a copay accumulator program. If you weren’t able to attend the webinar live, you can view a recording of it here.
  • Medicare Open Enrollment Brochure
    • Last month, Aimed Alliance published a brochure to assist consumers select a Medicare plan during the open enrollment period. This brochure contains comprehensive information on both traditional Medicare and Medicare Advantage plans and explains the differences between these types of plans. The brochure is intended to help consumers select the plan that is right for them based on the treatments and services they need most. If you or a loved one qualify for Medicare, view our brochure.
  • CMS Marketplace Overview
    • CMS has released a two-week enrollment snapshot that indicates how the health insurance marketplaces are performing based on how many people have signed up for a health plan during the first two weeks of open enrollment. This year’s open enrollment period, which lasts from November 1, 2019 to December 15, 2019, has seen roughly 245,000 new and 901,000 returning consumers. These numbers are slightly below last year’s enrollment during the same period. The slight decrease in enrollment could be attributed to a number of factors, including technical issues with the Healthcare.gov website, less awareness among consumers about open enrollment generally, the elimination of the individual mandate penalty, or aggressive marketing of short-term plans.
  • DOL Association Health Plan
    • The court case challenging the validity of the Department of Labor’s Association Health Plan rule is before the U.S. Circuit Court of Appeals. If a ruling is not issued by December 15, 2019, when open enrollment ends, the Trump Administration will have to enforce the lower court’s ruling. The lower court held that the Department of Labor’s rule was invalid.
       
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