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Aimed Monthly, Volume 1, Issue 2

Welcome to Volume 1, Issue 2 of Aimed Monthly! In this issue, we have a few developments to share regarding recent proposed rules that the Centers for Medicare & Medicaid Services (CMS) has issued and a new resource for advocates to help them track enacted laws on key health policy topics. We have also included a special legislative update in this issue highlighting national trends in state bills.

Highlights

Obstacles to Access
CMS proposed a rule that would weaken Medicare Part D’s Six Protected Classes. If this rule is finalized, Medicare beneficiaries who have historically faced difficulties in obtaining necessary treatments, such as those with epilepsy, Parkinson’s disease, certain mental health conditions, lupus, HIV/AIDS, and cancer, and those who need organ transplants, may once again face access barriers. The rule would also reverse a policy that had previously prohibited step therapy in Medicare Advantage (MA) plans. Under the proposed rule, MA plans could require patients to try and fail on Part D medications before being able to access prescribed Part B medications. Aimed Alliance submitted a comment in response to this proposed rule. View our comment here.
Marketplace Madness
CMS has issued another proposed rule that impacts health plans sold on marketplace exchanges, titled the 2020 Notice of Benefit and Payment Parameters. This rule would allow health plans to make mid-year formulary changes and adopt copay accumulator programs. Additionally, CMS is requesting feedback from stakeholders regarding the practice of “silver loading.” The deadline to submit a comment is February 19.
What a View! 
We have been compiling research on enacted laws related to evolving issues in health policy. This past month, we published this research to our website. In addition to our active legislative maps related to nonmedical switching, prior authorization, step therapy, association health plans, and short-term plans, you can now also view maps of enacted laws involving nonmedical switching, prior authorization, and step therapy. This resource will be updated regularly. If there’s something missing, let us know!
 

Media Coverage


Below is a list of recent events and publications featuring our work.
  • Click Here to listen to an episode of The Cancer Gene podcast hosted on iHeart Radio featuring Aimed Alliance counsel Stacey L. Worthy and staff from the Gabrail Cancer Center in Canton, OH. This episode focused on the practice of nonmedical switching in the hospital setting.
  • Click Here to watch Aimed Alliance Staff Attorney John A. Wylam speak at the FDA’s Bone, Reproductive, and Urologic Drugs Advisory Committee (BRUDAC) hearing on Jan. 16 regarding the approval of a new medication to treat osteoporosis.
  • Click Here to read an article published by Consumer Reports exploring billing challenges patients face when receiving preventive care services that should be free. This article features commentary from Aimed Alliance, the Doctor-Patient Rights Project (DPRP), America’s Health Insurance Plans (AHIP), and patients who have experienced this issue firsthand.
  • We published a survey in Oct. 2018, which was designed to gauge providers’ perceptions of utilization management techniques such as step therapy and prior authorization. Over the past month, this survey has been featured on StudyFinds, Newsmax, and Daily Mail UK.

State Legislative Update

  • Rhode Island Sen. Joshua Miller (D) has introduced S 137, which would require pharmaceutical manufacturers to offer coupons and discounts to people regardless of their insurance status. Additionally, this bill would require pharmacists to educate patients about lower-cost generic options before filling a prescription for a brand medication with assistance from a manufacturer. If this is a topic that is important to you, you can contact the legislator by email: sen-miller@rilegislature.gov.
  • New Hampshire Rep. Garrett Muscatel (D) has introduced HB 717, which would completely ban the pharmaceutical manufacturers from offering coupons or discounts to cover an individual’s out-of-pocket costs or deductible. If this is a topic that is important to you, you can contact the legislator by email: garrett.muscatel@leg.state.nh.us.
  • Multiple states have introduced legislation to impose a fiduciary duty on pharmacy benefit managers (PBMs). These bills commonly require PBMs to serve as a fiduciary to the health plans with whom they contract.
 

Events

  • We will be co-hosting a webinar with the Derma Care Access Network on March 21 from 12pm-1pm EDT. We will be discussing the impact of dermatological conditions, such as psoriasis and atopic dermatitis, in the workplace. You can register for the webinar here.
 

In Case You Missed It

  • Last month, we submitted a comment to CMS regarding the Trump Administration’s International Pricing Index proposal for Part B medications.
  • We also submitted a comment to CMS regarding its proposal to include medication list prices in direct-to-consumer advertising.
  • This month, we published a revised version of our brochure for patients with migraine disorder to help them navigate disability and discrimination issues in the workplace.
Contact Us
Questions, comments, suggestions, or feedback? Send us an email.
Copyright © 2019 Aimed Alliance, All rights reserved.


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