Though Congress is in August recess, we’ve got details on some of the hot topics in health care that will be discussed and debated for the remainder of 2019. Read on to get the scoop!
Addressing Prescription Drug Costs
Transformative medicines make a substantial difference in the lives of people with arthritis, but the out-of-pocket costs are significant. We’ve got you covered and are taking action: Last month, we released a new issue brief addressing the cost of prescription drugs. Throughout the summer, we’ve been telling key lawmakers that drug pricing policies should benefit the people they are intended to serve: patients. And there is a lot more work to be done on increasing health care transparency, addressing value-based care and reforming the drug supply chain. Both the House and Senate are considering several bills to tackle drug costs in a way that preserves patient access to needed medicines. This fall, keep your eyes on Congress for all the action.
Surprise bills often occur when a patient receives treatment in a health care facility where numerous providers may be involved in their care. Sometimes, one or more of those providers are not in the patient’s insurance network. What this means is that patients will often receive unexpected bills through no fault of their own. How is a patient supposed to know the anesthesiologist wasn’t in-network for a knee replacement surgery? Congress and the White House are very interested in reforming surprise billing practices by keeping patients out of the middle and allowing payment disputes between providers and insurers to be resolved fairly. Because it’s an important bipartisan issue, we’ve been spotlighting the need for reform — and even have an issue brief! Check it out here, and don’t forget to share your story with us in our Advocacy Storybank.
People with arthritis often face unnecessarily long delays in accessing needed care due to burdensome prior authorization requirements. The Arthritis Foundation has been leading the way on reforming prior authorization at the federal and state levels. In fact, we were the only patient organization to participate in the development of prior authorization principles in 2017 with the American Medical Association. Overly burdensome prior authorizations reduce the time providers spend away from direct patient care. Earlier this summer, federal legislation was introduced to address it. The Improving Seniors’ Timely Access to Care Act (H.R. 3107) is a bipartisan bill to ensure access to evidence-based care for Medicare Advantage enrollees by establishing common sense patient guardrails around prior authorization. The bill is supported by over a dozen patient and provider organizations, including the Arthritis Foundation. It’s a strong first step to reform prior authorization protocols in Medicare and beyond. Give our letter of support a peek.
Short-Term Health Plans
Open enrollment season is almost upon us — and you’ll need to be on the lookout for short-term health plans. These types of plans are generally bad for people with chronic disease like arthritis because they cover very few medical services, including prescription drugs. As the name suggests, short-term health plans are meant to fill in temporary gaps in coverage. But in July a federal judge allowed a regulation to go forward that would expand these types of plans. The court ruled short-term plans can be sold 364 days of the year, with options to renew them up to 36 months. The plans may seem attractive due to lower premiums, but they do not need to meet the essential health benefits. You can read more about short-term health plans here.
In the coming months the Arthritis Foundation will be raising awareness about the open enrollment period, but you can get started with the Your Coverage, Your Care toolkit. It’s a great resource to help you understand your insurance options, the claims process and tips to overcome barriers. Additionally, if you have any questions about your health care, licensed clinical social workers are available to talk with you 24 hours a day at your convenience. You can reach the Arthritis Foundation Helpline toll-free at 844-HELP (4357).
If you’d like to stay informed on federal- and state-based health care issues, consider signing up to be an Advocate. Becoming part of our advocacy grassroots network is an easy way to get involved and stay informed. Plus, you can share your arthritis story, too.