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Aimed Monthly, Volume 1, Issue 1

Happy New Year from Aimed Alliance! In this issue of Aimed Monthly, we’re featuring regulatory comments, a fact sheet on Medicare Part D, a newly-passed step therapy law, and state advocacy developments regarding nonmedical switching.

Highlights

The Wrong Direction
Last quarter, the Trump Administration proposed implementing an “International Pricing Index” for medications covered by Medicare Part B. This proposal would dramatically alter the prescription drug supply chain for providers participating in the Part B program and could significantly impede the ability of seniors to access their medications. Explore our response to this proposal.

White Noise
Another proposal from the Trump Administration would require the inclusion of list prices in direct-to-consumer advertisements for pharmaceuticals. Read more about our findings on how this proposal could confuse and mislead consumers.

The Looming Cliff
Beginning in 2020, a provision of the Patient Protection and Affordable Care Act is set to expire, which would dramatically increase the cost-sharing responsibilities for Medicare Part D medications. This has become known as the “Part D Cliff.” Review our fact sheet to learn more about the Part D Cliff and how it could affect you or your loved ones.

Stop Switching My Medications!
In December, Aimed Alliance distributed a sign-on letter to hospitals and health systems in Ohio. This letter expressed concern about these actors engaging in nonmedical switching practices that can hurt patients by interrupting their continuity of care. Learn more about how hospitals and health systems are engaging in nonmedical switching and why we oppose this practice.

Accumulator Outreach

Following the release of our report titled Employers Beware: Understanding the Costs and Liability Risks of Health Insurance Copay Accumulator Programs, we have engaged with various stakeholders to mobilize them on the issue of copay accumulators. So far, we have distributed this report to 50 state attorneys general, 50 state insurance commissioners, chief executive officers and human resource directors at Fortune’s “100 Best Companies,” 15 employer associations, the House Education and Workforce Committee, and representatives at the Federal Trade Commission (FTC), the Department of Labor (DOL), the Centers for Medicare and Medicaid Services (CMS), and the Center for Consumer Information and Insurance Oversight (CCIIO). Look for future developments on this front.

Media Coverage

Below is a list of recent notable news articles featuring our work.

Xtelligent Healthcare Media quoted Aimed Alliance counsel Stacey L. Worthy in its article on Preventive Care.
CBS discussed how to appeal an insurer’s refusal to cover emergency room services, leaving patients on the hook for extraordinary costs. CBS featured guidance from Aimed Alliance counsel Stacey L. Worthy on how to successfully appeal a denied insurance claim.
Pharmaceutical Commerce featured Aimed Alliance’s recently published report on copay accumulator programs in an article discussing the issue.

In Case You Missed It

In January, Ohio's governor signed new step therapy legislation. Review the text of the legislation to learn more or read the governor’s press release.
In our last issue, we featured the second installment in our three-part series titled Common-Sense Steps to Reduce the Cost of Health Care in the U.S. Part II of this series focuses on steps that health insurers, pharmacy benefit managers, and pharmaceutical manufacturers can take to lower costs for consumers, while Part I discussed the federal government’s role. Part III, which will discuss the role of pharmacies, practitioners, and consumers, is forthcoming this spring.

Contact Us
Questions, comments, suggestions, or feedback? Send us an email.