Medicare Part B Demonstration Proposal Withdrawn

Victory – Medicare Part B Demonstration Proposal Withdrawn!

Arthritis Advocate Medicare Part B Demonstration Proposal
Arthritis Foundation Advocate, Amy Barron, along with Senator Rob Portman (R-OH).

Amy Barron lives with rheumatoid arthritis and osteoporosis. Her treatment includes biologic infusions that are administered under careful supervision by her physician. When Amy receives her infusion, she is in a familiar environment – her rheumatologist’s office – and her care is supervised by someone who knows her unique medical history, understands the complicated nature of her condition and can monitor her treatment and knowingly respond to adverse reactions.

This reliable routine was recently put in jeopardy with the introduction of the Medicare Part B Demonstration Proposal. Introduced by the Centers for Medicare and Medicaid Services (CMS), the proposal was intended to reduce physician-administered infusion and injected medication treatment costs by encouraging physicians to prescribe less expensive treatments and restructuring how providers are reimbursed.

If enacted, the Medicare Part B Demonstration Proposal would have made it exceeding more difficult for rheumatologists to obtain and administer biologic treatments in their offices and clinics, leaving some patients without treatment options and pushing others toward more expensive facilities, like hospitals, for their care.

For people with arthritis, this means they would be forced to get treatment at a local hospital from someone who is not intimately familiar with their medical history. Their out-of-pocket expense would significantly increase, their ease of accessing treatment would decline and they would be unnecessarily exposed to hospital germs, increasing their risk of infection and disease.

Today we celebrate the defeat of the Medicare Part B Demonstration Proposal which was withdrawn by the Obama administration.

“This success is testimony to the strength of our Arthritis Foundation Advocates who communicated their opposition to policy makers in person and through written communications,” said Sandie Preiss, national vice president of Advocacy & Access. “Our voices are being heard and policies that are not focused on the needs of patients are being rejected.”

This victory would not have been possible if it weren’t for our advocates, like Amy, who made it their mission to share their story and make change happen. Their work included:

  • Ann Palmer, president and CEO of the Arthritis Foundation, authoring an op-ed with the American College of Rheumatology that was published in the April 21, 2016 issue of The Hill and asking for the Centers for Medicaid and Medicare Services to withdraw the proposal.
  • 1,700 letters from Advocates sent to their legislators asking them to sign a Congressional letter opposing the proposal. More than 240 legislators signed the letter.
  • Authoring a patient-provider letter to Congress that explained how the proposal would hurt the arthritis community. The letter was signed by more than two dozen other patient and provider organizations.
  • Signed a letter to the Centers for Medicaid and Medicare Services that was authored by the Coalition for Accessible Treatments and opposed the proposal.
  • Authored a formal comment letter to the Centers for Medicare and Medicaid Services outlining our concerns, asking for the proposal to be withdrawn and requesting that future strategies for reducing the cost of drugs be developed in consultation with patient groups, like the Foundation.

“This proposal would have taken the focus away from the patient and quality care,” said Amy. “Ultimately, it would have led to less accessibility to some medications and facilities which have been lifesaving for patients with diseases like rheumatoid arthritis, other autoimmune diseases and cancer.”

Now that the Medicare Part B Demonstration Proposal has been withdrawn, people with rheumatoid arthritis and other patients who receive infused drugs that are covered on Part B can rest assured that they can still receive their treatments at their treating physician’s office, without having to change treatment sites or medications and without unnecessary additional expenses or hassle.

Do you have a story to tell? Sign up to be an advocate today and we’ll prepare you with the tools and resources to make a positive impact on your local, state, and federal policy. Joining our advocacy community is easy and a great way to learn how to use your story to do some good. You can sign up to be an advocate today and don’t forget to make plans to attend the 2017 Advocacy Summit, March 6-7, in Washington DC!



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2 thoughts on “Victory – Medicare Part B Demonstration Proposal Withdrawn!

  1. Hi, my healthcare advocate said to contact. I have many fake joints and other joints which my dr treats me with chemical enervation with botulism A and other drugs. Also, medicare flex with FidelisCare and medicare do not cover fully. Also, massage therapy which would have some help is not covered either. Please advise what I can do.

    Thank You

  2. What good is some of these biologics that doctors prescribe for Rheumatoid if your co pays are un reachable, I am a senior and can afford 1,200 out of pocket.
    And I can try to reach some of these companies to help but they want to know everything about your monetary status. I am in a pickle trying to get help.

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