On Thursday, October 12, 2017, the Administration took two actions on health care that could affect coverage for people who have health insurance through the exchanges.
President Trump signed an executive order that opens the door for the expansion of association health plans, which aren’t subject to the same level of patient protections as required by the Affordable Care Act (ACA). Second, the Administration announced the discontinuation of cost-sharing reduction payments, which are payments to health insurers that help reduce out-of-pocket costs for low income people who purchase insurance on the health exchanges.
Read on to learn more about the Administration’s actions and their potential impacts on the arthritis community.
Continue reading Answering Your Questions About the Latest Administration Actions on Health Care
Our Advocates have been busy. Very busy. And the results are fantastic!
Due in part to tireless work by our volunteer Advocates, 9 states passed legislation within the first six months of 2017 to address issues with biosimilar medications.
Continue reading Nine Major Wins in 6 Months!
Exciting news in Texas! On May 23, Governor Greg Abbott signed Senate Bill 680 into law, limiting the use of step therapy. Texas now joins a growing number of states that have enacted laws that regulate the use of step therapy. With over 4 million adults and 24,900 kids with doctor-diagnosed arthritis in Texas, this is a major victory!
Step therapy is used by health insurance providers to control the order and use of prescriptions drugs. A patient could be required to try and fail lower-cost or other drugs selected by their insurance provider before coverage is granted for the drug prescribed by the patient’s treating physician. For patients, this barrier to care prevents timely access to doctor prescribed treatments and can be the difference between full mobility and joint damage.
Continue reading Victory in Texas – Legislation Limits Step Therapy
We applaud Maryland Governor Larry Hogan for joining 28 other states in creating a pathway for the substitution of biologic medications with biosimilars by signing the Pharmacists – Substitution and Dispensing of Biological Products bill into law.
Biologics are life altering drugs for people with arthritis and are very complex products made with living cells. Because of this complexity they are expensive. Biosimilars, are a new class of drugs that are similar to biologics. They have the potential to lower medication costs.
Continue reading Victory for Maryland! Biosimilar Bill Signed by the Governor!
It’s not uncommon for patients to change their insurance carriers. Sometimes it’s by choice, perhaps because they find a carrier that better suits their needs. Other times, it might be out of their control, like when their employment changes. Regardless of why carriers are changed, should patients be required to restart the utilization management process with their new insurance carrier, essentially starting over and potentially undoing years of effective and consistent care? Continue reading California Advocates Work for Passage of Bill That Will Improve Continuity of Care When Insurance Carrier Changes
The Iowa arthritis community is celebrating Governor Branstad signing into law House File 233 on May 10, 2017.
The bill, unanimously passed by both chambers, puts limits on an insurance industry protocol known as step therapy which requires patients to try and fail medications identified by the insurance company before agreeing to cover medications prescribed by the treating physician. The bill will increase access to care for arthritis patients by limiting step therapy practices in Iowa.
Continue reading Victory in Iowa! Governor Branstad Signs into Law a Bill to Curb Step Therapy!
Congratulations D.C. Advocates! Because of your efforts, Washington, D.C. Mayor Muriel Bowser signed the Specialty Drug Copayment Limitation Act. In the law, “specialty drug” means a prescription drug that is prescribed for a person with a physical, behavioral, or developmental condition that may have no known cure, is progressive, or can be debilitating or fatal if left untreated or undertreated, such as multiple sclerosis, hepatitis C and rheumatoid arthritis.
Continue reading The Nation’s Capital Caps the Out-of-Pocket Costs of Medications
Step therapy is a cost saving tactic used by insurers that requires people with arthritis and other potentially debilitating conditions to try and fail lower-cost medications before covering more expensive treatments. In other words, insurance companies oftentimes disregard treating physicians’ knowledge of their patients and related expertise, forcing patients to try cheaper medications, all to save a few dollars.
Continue reading Step Therapy Win in West Virginia!
Iowa has recently joined 27 other states that have passed biosimilars legislation. On behalf of the 619,000 adults (plus 2,800 children) in Iowa with doctor-diagnosed arthritis, we’d like to thank Governor Branstad for signing House File 305 into law on Friday, March 10, 2017.
The bill allows Iowa pharmacists the ability to dispense safe and potentially less expensive biologic medications to patients, by substituting an FDA approved interchangeable biosimilar for a prescribed biologic product. The law also requires that the prescriber and patient be notified when there is a substitution.
Continue reading Victory in Iowa: Biosimilar Legislation Signed Into Law!
For years now, many arthritis patients have utilized biologic medications to great effect. Biologics have allowed those with arthritis, as well as many other chronic diseases, to stabilize their condition and help them better quality lives. Now, due to innovation, new medications are coming to market which could provide arthritis patients with more, and potentially less expensive, options. These new medications are called “biosimilar” medications which are similar to, but not exact copies of name brand biologics.
Continue reading Victory in Montana! Governor Bullock Signs Biosimilar Substitution