Considering a Medicare Advantage plan for 2019?
An important change is coming that you should know about!
The administration recently released guidance that allows Medicare Advantage (MA) plans to use step therapy. This is new for next year and a few health insurers have already said they will institute the policy. In this week’s Take Care blog, we break down the issue to help you make the best choice during open enrollment season. Remember: Medicare open enrollment has already started and continues through December 7. Read on to get the scoop on this change to Medicare Advantage plans.
Mark your calendars! This year’s Live Yes! Advocacy Summit will take place on March 11-12, 2019 in Washington, D.C. and it won’t be a success without your voices from across the country. Join us in the nation’s capitol and share your story with policymakers to break down barriers to care for people with arthritis.
On Thursday, February 1, the Arthritis Foundation and American College of Rheumatology (ACR) – along with seven other health advocacy organizations – will host a briefing on Capitol Hill urging lawmakers to increase research funding at the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the U.S. Department of Defense (DoD) to combat the nation’s leading cause of disability.
New data reveals the stunning impact of arthritis on the U.S. economy. Between 2003 and 2013, the annual cost of arthritis more than doubled and now totals $304 billion in direct and indirect costs, according to a CDC-sponsored study published in the September 2017 edition of Arthritis Care & Research. These figures include both higher medical costs to patients, as well as lost earnings from individuals who are unable to work due to their condition.
On Wednesday, December 20, Congress passed the Tax Cuts and Jobs Act (TCJA). There were several health-related changes included in the legislation, such as a repeal of the Affordable Care Act’s individual mandate, and changes to the medical expenditure tax deduction. Below we explain the key health provisions that made it into the final law, how it may impact you, and what’s next.
Let’s start with the individual mandate.
Continue reading Answering Your Questions About the New Tax Reform Legislation
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.
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