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Aimed Monthly, Volume 2, Issue 3

Welcome to Volume 2, Issue 3 of Aimed Monthly! This month’s issue of Aimed Monthly includes several health policy updates, including the latest developments at the state and federal level regarding Coronavirus Disease 2019 (COVID-19), the federal court case challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA), an initiative to educate congress members about copay accumulators, a non-medical switching complaint sent to a health insurer, and new maps of active legislation and enacted laws available on the Aimed Alliance website. Begin reviewing these important updates below!

COVID-19

Aimed Alliance Creates COVID-19 State Legislation and Enacted Laws Maps 
To keep you up to date on state legislative activity on COVID-19, Aimed Alliance has created new maps containing active legislation and enacted laws related to the COVID-19 pandemic. Our maps include government efforts to slow the spread and reduce the public health impact of coronavirus, including increasing access to preventive services, COVID-19 testing and treatment, new open enrollment periods, and surprise medical bill protections. Review the active legislation here and enacted laws here.
Federal Legislative Actions on Coronavirus 
  • On March 6, President Trump signed into law the first federal relief package, titled the Coronavirus Preparedness and Response Supplemental Appropriations Act.
    • This package authorizes $8.3 billion in additional funds to federal agencies, including $3.1 billion in additional funds for the United States to purchase vaccines, therapeutics, and diagnostics, $300 million to the Centers for Disease Control and Prevention for global disease detection and emergency response, and $836 million to the National Institutes of Health to prevent, prepare for, and respond to coronavirus.
  • On March 18, 2020, the President signed into law a second coronavirus relief package, titled the Families First Coronavirus Response Act.
    • This package provides over $850 billion in relief to Americans, including paid sick leave and nutrition assistance for individuals affected by coronavirus, expanded unemployment benefits, and free coronavirus testing for all Americans regardless of their source of insurance.
  • On March 19, 2020, Senate Majority Leader Mitch McConnell introduced a third relief package, titled the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
    • This package is designed to reduce damage to the U.S. economy. It contains a financial bailout for industries that will be most affected by coronavirus, including the airline industry; small business loans; financial assistance for American taxpayers; an exception that will allow Americans to avoid the 10 percent penalty for coronavirus-related withdrawals from their 401(k) made before retirement age; a delay of the tax filing deadline from April 15, 2020 to July 15, 2020; and more.
Federal Regulatory Activity on Coronavirus 
  • On March 9, the U.S. Food and Drug Administration and the Federal Trade Commission issued warnings to seven companies selling fraudulent products that claimed to treat or prevent COVID-19. At this time, there is no known “cure” to the virus.
    • Since then, several companies selling cannabidiol (CBD) products have made similar misleading claims. See here, here, here, and here.
  • On March 13, CMS released a notice in response to the COVID-19 Emergency Declaration. In it, CMS explained that it would take proactive steps through 1135 waivers and rapidly expand the Administration’s aggressive efforts against COVID-19.
    • Available blanket waivers include waivers for certain requirements related to skilled nursing facilities, critical access hospitals, housing acute care patients in excluded distinct part units, durable medical equipment, and telehealth, among others.
  • On March 17, CMS approved a 1135 waiver for Washington’s Medicaid program, and on March 19, CMS approved a 1135 waiver for Florida’s Medicaid program.
    • These waivers include a streamlined provider enrollment process, extended deadlines for appeals and state fair hearing requests, elimination of prior authorization requirements, and reimbursement for facilities forced to evacuate into unlicensed facilities.
  • On March 18, CMS announced that catastrophic health plans could offer coverage of services associated with the diagnosis and treatment of COVID-19 prior to plan enrollees meeting their deductibles.
  • On March 20, the U.S. Drug Enforcement Administration (DEA) announced that DEA-registered practitioners could prescribe controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided that certain conditions are met.
  • California, Florida, New York, and Washington have experienced the highest concentrations of confirmed COVID-19 cases and deaths caused by the disease.
  • Two states, Massachusetts and New Mexico, have implemented policies that will require health plans to waive cost-sharing for COVID-19 treatment.
  • Seven states, Kentucky, Maine, Massachusetts, New Hampshire, Pennsylvania, Rhode Island, and Washington, have waived prior authorization requirements for COVID-19 testing. Two states, Massachusetts and Washington, have waived prior authorization requirements for COVID-19 treatment.
  • Another 11 states have required health plans to allow enrollees to refill their prescriptions early.
  • Eight states and the District of Columbia have opened a special enrollment period for consumers to enroll in a health insurance plan. This includes California, Connecticut, Maryland, Massachusetts, Nevada, New York, Rhode Island, and Washington.

Highlights

Certiorari in Texas v. Azar
On March 2, 2020, the Supreme Court of the United States granted certiorari in Texas v. Azar, the lawsuit challenging the constitutionality of the ACA after the law’s penalty for not maintaining health insurance coverage was reduced to $0. With the grant of certiorari, the Supreme Court has agreed to hear this case and will ultimately decide the fate of the health care reform law. The case is likely to be heard in Fall 2020 with a decision expected in mid-2021. Moving forward, the consolidated lawsuit is titled Texas, et. al. v. California, et. al. To learn more about this lawsuit and how it could affect the U.S. health care system, review this article recently published by Kaiser Health News.
 
Stay tuned for additional updates on this critical health care lawsuit.
HealthPartners
On March 9, 2020, Aimed Alliance sent a sign-on letter to HealthPartners, which is a nonprofit health care provider and health insurance company located in Minnesota and operating nationwide. The letter, joined by over 25 health care providers, patients, and patient advocates, was sent in response to the health insurer’s decision to end coverage for a medication in the middle of the plan year, which will become effective on April 1, 2020. As a result, stable patients will be required to change their medication. Read our letter to learn more about these issues.
Bad Trial Ad Legislation and Enacted Law Maps
In addition to our new COVID-19 maps, Aimed Alliance also recently created new maps to track active legislation and enacted laws on “bad trial ads.” These are deceptive advertisements soliciting participation in class-action lawsuits against pharmaceutical manufacturers and medical device makers. Review bad drug ads active legislation here, and enacted laws here.

Legislative Update

  • KY HB 72
  • NJ S 2131
    • On March 16, 2020, New Jersey Senator Nia Gill introduced S 2131, which would prohibit the sale of association health plans and short-term, limited duration health plans in New Jersey if they do not meet certain requirements. These protections include prohibiting pre-existing condition exclusions, covering essential health benefits, and requiring health plans to allow continuation of dependent health benefits until the age of 26.

Media Coverage

  • On March 16, 2020, the Washington Times-Reporter published an op-ed by Aimed Alliance counsel Stacey L. Worthy. This opinion piece discusses how health care access barriers, such as prior authorization and step therapy, can harm patients. Additionally, Ms. Worthy analyzes the implementation of new patient protection laws in Illinois, the degree to which health plans are complying with those laws, and offers insights on how patient protections become even more important during public health emergencies like the current coronavirus pandemic. Ms. Worthy’s op-ed was also published by the Journal Star.

Where We've Been

  • Aimed Alliance Copay Accumulators on the Hill
    • Earlier this month, Aimed Alliance joined Patients Rising Now to advocate for federal policymakers to abandon a provision in the Notice of Benefit and Policy Parameters (NBPP) for 2021 that would allow health plans to implement copay accumulator programs broadly. Aimed Alliance and Patients Rising Now’s efforts contributed to over 70 members of Congress signing onto a letter to the U.S. Department of Health and Human Services, advocating that the agency revert back to last year’s NBPP, which only allowed copay accumulators in instances where both brand-name and generic medications are available.

In Case You Missed It

  • CBD Reports
    • On March 5, 2020, the U.S. Food and Drug Administration (FDA) issued a report to Congress on the agency’s progress toward obtaining and analyzing data, developing a regulatory pathway for hemp-derived CBD products, and enforcement discretion. The FDA was charged with creating the report as a result of a provision of the Further Consolidated Appropriations Consolidation Act, 2020, which was enacted on December 20, 2019. However, the report does not reveal much new information.
    • On March 5, 2020, Digital Citizens Alliance released a new report on CBD products. The report, titled “CBD Confusion: How Consumers Can Be Misled and Why the Market Needs Adult Supervision Now,” presents the findings of the organization’s investigation into CBD products sold online and the results of national surveys to assess Americans’ use and understanding of CBD products. The report found that half of products purchased and tested by Digital Citizen contained CBD levels that were 20 percent higher or lower than what was listed on the packaging.
  • Medicaid Work Requirements in Michigan
    • On March 4, 2020, the United States District Court for the District of Columbia issued its ruling in Young v. Azar. In its decision, the court invalidated Michigan’s proposal to implement work requirements in the state’s Medicaid program, which was originally scheduled to become effective in January 2020.
Contact Us
Questions, comments, suggestions, or feedback? Send us an email.
Copyright © 2020 Aimed Alliance, All rights reserved.


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