arthritis advocacy news and regulatory letters

Advocacy News & Regulatory Letters

September 19, 2018

Arthritis Foundation Sends Letter on Pre-Existing Conditions Legislation

On September 19, the Arthritis Foundation joined with nearly three dozen patient and provider groups in a letter about legislation designed to address concerns with the potential impact of a court case in Texas that could roll back pre-existing conditions protections. While we believe the legislation is well-intended, it does not encompass all of the patient protections under current law. Read the letter here.

September 4, 2018

More Than 25 Patient and Consumer Groups Issue Statement on Pre-Existing Conditions Bill

On September 4, the Arthritis Foundation joined over two dozen patient and consumer groups in a statement expressing both appreciation and concern for legislation introduced in the U.S. Senate, which would prohibit the denial of coverage based on health status, but would not ban pre-existing condition exclusions or prevent insurers from varying premiums based on age, gender, or occupation. This means that people with chronic diseases could still face higher premiums and out-of-pocket costs. Read the statement here.

August 30, 2018

Arthritis Foundation Statement on CMS Guidance Providing for Indication-Based Drug Coverage in Part D

The Arthritis Foundation released a statement in response to the administration’s announcement of new guidance to Medicare Part D prescription drug plans about the use of indications-based formulary design. The type of plan design means that a drug could be placed on a formulary only for the specific indication for which it is most effective. This policy would likely further restrain the already narrow available treatments for inflammatory forms of arthritis. Read our statement here.

August 22, 2018

Arthritis Foundation Expresses Concern about Association Health Plan Provision in Farm Bill

The Arthritis Foundation joined 19 patient and health organizations to urge conferees of the Agriculture and Nutrition Act to omit language from the final conference report that would assist in the establishment of agriculture association health plans (AHPs). This language could impact access to affordable, adequate health insurance coverage for people with arthritis. Although many of our organizations expressed distaste for AHPs earlier in the year, these concerns were disregarded. Read the statement here.

August 16, 2018

Arthritis Foundation Comments on Reopened Kentucky Medicaid Waiver

On August 16, the Arthritis Foundation submitted comments to the Centers for Medicare and Medicaid Services (CMS) on Kentucky’s waiver application, which seeks to include work requirements in Medicaid. CMS is the federal agency responsible for working with states to jointly administer the Medicaid program. Our comments focused on the complexities of treating arthritis on top of the administrative burden associated with a work requirement policy. Read our letter here.

August 8, 2018

Arthritis Foundation Statement on Step Therapy in Medicare Advantage

The administration announced a policy change that would permit Medicare Advantage plans to implement step therapy protocols. We have long been guided by the principle that patients who are stable on a medication should be able to remain on that medication. We're concerned this announcement could have unintended consequences or adverse impacts on patient health. Read our statement.

August 1, 2018

Arthritis Foundation Deeply Troubled by Administration’s Decision to Finalize Short Term Health Plan Regulation

The Arthritis Foundation joined 26 patient and consumer organizations to release a statement expressing significant concerns with a final regulation that expands short-term, limited duration health plans. Over 98 percent of health care stakeholders opposed the proposal last April yet these collective concerns were disregarded. Read the statement here.

July 25, 2018

Arthritis Foundation Applauds Focus on Health Savings Accounts by the House of Representatives

Today, the House of Representatives is scheduled to consider two bills addressing health savings accounts (HSAs). These types of accounts are paired with high deductible health plans (HDHPs). While these arrangements are by no means a comprehensive solution, we have consistently heard from people with arthritis who are increasingly enrolled in these plans and want greater flexibility to feel more confident health care needs are being met. Read our statement.

July 24, 2018

Arthritis Foundation Expresses Concern About New Insurance Practice That Could Increase Patient Out-of-Pocket Costs

Fifty-eight patient, provider, and consumer groups sent letters to every state insurance commissioner to sound the alarm on an emerging insurance practice that affects how a drug manufacturer copay card is applied to a patient’s deductible. The Arthritis Foundation does not take a position on copay cards but has heard from a number of arthritis patients that they have encountered this new insurance practice. Read the statement and a sample letter here.

July 16, 2018

Arthritis Foundation Submits Comments on Administration’s Drug Pricing Blueprint

On July 16, the Arthritis Foundation submitted comments to the federal Department of Health and Human Services in response to a request for information about strategies and opportunities to lower drug prices and reduce patient out-of-pocket costs in the Medicare program. Our letter emphasized that drug pricing and affordability are two issues that deeply impact people with arthritis, and we urged the administration to keep the patient perspective at the center of policy decisions. Read the letter here.

July 11, 2018

Arthritis Foundation Statement on Latest Health Insurance Marketplace Actions Taken by the Administration

Over the last week, the administration took two actions that have the potential to further destabilize the individual health insurance market by deciding to freeze certain payments to insurers that participate on the health insurance exchanges, and by cutting funding for organizations that help patients sign up for coverage. Read our statement on these actions here.

June 19, 2018

Arthritis Foundation Joins 25 Organizations Expressing Disappointment Over Association Health Plan Regulation

On June 19, the Arthritis Foundation and over two dozen patient and consumer groups issued a statement on a final regulation released by the federal Department of Labor that would expand the use of association health plans. Under the rule, these types of plans would not need to meet all of the consumer protections under current law, including essential health benefits such as prescription drug coverage. Read our statement here.

June 18, 2018

Arthritis Foundation Supports Legislation in House of Representatives That Bans Pharmacist Gag Clauses

On June 18, the Arthritis Foundation sent a letter of support to the lead sponsors of legislation that would allow pharmacists to inform patients about alternative options to lower out-of-pocket costs. Today, so-called gag clauses prohibit a pharmacist from informing a patient about whether their medication could be cheaper if they paid cash versus using their health insurance. The bill is similar to legislation introduced in the U.S. Senate. Read the letter here.

April 20, 2018

Arthritis Foundation Submits Comments on Short-Term Plan Proposed Regulation

On April 20, the Arthritis Foundation submitted public comments to the federal Departments of Health and Human Services, Labor, and Treasury expressing concern about the administration’s proposal to expand the duration of short-term health plans. These types of insurance plans are not required to offer coverage for essential health benefits, such as prescription drugs, and can do not include protections for people with pre-existing conditions. The Foundation’s comments focused on the importance of patient protections under current law and the need to avoid finalizing the regulation as proposed. Read the letter here.

April 16, 2018

Arthritis Foundation Joined by Ten Patient and Provider Groups in Support of Federal Bill Addressing Gag Clauses

On April 16, the Arthritis Foundation sent a letter of support for legislation that would prohibit health plans from using so-called gag clauses, which can be used to prohibit the disclosure of pricing options to patients. Some pharmacists are required to sign “gag orders,” which can prevent a patient from making the cheaper choice of paying out of pocket for medication at the pharmacy counter, rather than paying a higher co-payment if they had used their health insurance. Read the letter here.

March 6, 2018

Arthritis Foundation Signs Letter Expressing Concern with Proposals to Expand Association Health Plans

The Arthritis Foundation, along with 117 other patient and community organizations, signed onto an I Am Essential coalition letter to the federal Department of Labor expressing strong concerns with a proposal that would expand a type of insurance plan known as an association health plan. These types of plans would not be required to comply with important patient protections under current law such as the ten essential health benefits, including prescription medications. In addition, the plans would not be required to cap a patient's out-of-pocket maximums for deductibles, co-payments, and co-insurance. Read the letter here.

February 26, 2018

Arthritis Foundation Urges Increased Funding of the CDC Arthritis Program for the Remainder of Fiscal Year 2018

On February 26, the Arthritis Foundation sent two letters to leaders of the health committees in Congress that oversee funding for the Centers for Disease Control and Prevention (CDC) Arthritis Program. In the letters, we urged increased investment in the CDC's Arthritis Program for the current fiscal year. The CDC's Arthritis Program is the only federal program dedicated solely to arthritis, and carries out important public health research and data collection. Thanks to the bipartisan budget agreement earlier this month, additional funding is now available for these types of programs. Read the House letter here, and the Senate letter here.

February 22, 2018

Arthritis Foundation Comments on Mississippi's Workforce Training Medicaid Waiver

On February 22, the Arthritis Foundation submitted comments to the federal Department of Health and Human Services (HHS) regarding Mississippi's proposal to institute work requirements for Medicaid patients. A major consequence of these requirements would likely be an increase in the paperwork burden for all Medicaid patients, making it more challenging for people to maintain health care coverage. Read the letter here.

February 22, 2018

Arthritis Foundation Comments on Wisconsin's Request to Extend Medicaid Waiver

On February 22, the Arthritis Foundation submitted comments to federal Department of Health and Human Services (HHS) expressing concern about the cost-sharing requirements proposed in the waiver application. In addition, the proposal would impose work requirements and place limits on how long Medicaid patients can receive benefits under the program. Arthritis is the leading cause of work-related disability in the United States and these types of proposals can create barriers to accessing health care coverage. Read the letter here.

February 21, 2018

Arthritis Foundation Applauds FDA's Biosimilar Educational Materials

On February 21, the Arthritis Foundation and National Psoriasis Foundation sent a letter to the Food and Drug Administration (FDA) expressing appreciation for efforts to advance innovative therapies and make biosimilar eduation materials available to health care providers. These educational tools can help prescribers learn about biosimilars and, subsequently, increase opportunities for patients to access new treatments. The letter also acknowledges our support for the FDA's scientific standards in evaluting the safety and efficacy of biosimilars. Read the letter here.

February 20, 2018

Proposed Short-Term Insurance Plans Could Leave Patients with Fewer Protections, Inadequate Coverage

On February 20, the Arthritis Foundation joined 16 patient and consumer groups to issue a statement on a proposed regulation released today by the federal Departments of Labor, Treasury, and Health and Human Services, which would expand the use of "short-term limited duration" insurance plans. The Arthritis Foundation is concerned these types of plans could exclude coverage for certain health care services, and allow insurers to charge individuals with a pre-existing condition higher rates. Read the statement here.

February 12, 2018

CDC Arthritis Coalition Statement on the President's Fiscal Year 2019 Budget Request

On February 12, the president released the administration’s official budget request for fiscal year 2019. The budget would make cuts to the Chronic Disease Division at the Centers for Disease Control and Prevention (CDC). The division houses the CDC Arthritis Program, the only federal program dedicated solely to arthritis. Read our coalition statement here.

February 9, 2018

Arthritis Foundation Praises Budget Deal, Permanent Repeal of Therapy Caps

Early Friday morning, Congress passed a significant bipartisan budget agreement that would fund many health care priorities important to the arthritis community, raise the budget caps for discretionary spending, and bring Congress closer to closing out work on the fiscal year 2018 appropriations process. Read our statement here. Do you want to learn more about the bipartisan budget agreement and what it means for the arthritis community? Click here to read our FAQ.

February 5, 2018

Arthritis Foundation Comments on Arizona's Proposed Medicaid Waiver

On February 5, the Arthritis Foundation joined a dozen patient organizations to submit comments to the federal Department of Health and Human Services (HHS) expressing concern about the cost containment proposals in the state of Arizona's Medicaid waiver application. The waiver would impose work requirements and place limits on how long Medicaid patients can receive benefits under the program. Our letter follows similar comments submitted to HHS about waiver applications from the states of Kansas and New Mexico. Read the letter here.

January 30, 2018

Arthritis Foundation Comments on Proposed Medicaid Waiver from New Mexico

On January 30, the Arthritis Foundation joined eight patient organizations to submit comments to the federal Department of Health and Human Services expressing concern about some of the policy proposals in the state of New Mexico's Medicaid waiver application. While the Arthritis Foundation shares the goals outlined in the application - such as proposals that would enhance the health of patients with arthritis through coordinated care - new cost sharing and eligibility requirements could pose significant access barriers for patients on Medicaid. Read the letter here.

January 26, 2018

Arthritis Foundation Comments on Proposed Medicaid Waiver from Kansas

On January 26, the Arthritis Foundation joined several other patient organizations to oppose aspects of a proposed Medicaid waiver from the state of Kansas by sending a letter to the federal Department of Health and Human Services. The Kansas waiver would impose work requirements and place time limits on how long Medicaid patients can receive benefits under the program. Arthritis is the leading cause of work-related disability in the United States and these types of proposals can create barriers to accessing or maintaining health care coverage. Read the letter here.

January 25, 2018

Arthritis Foundation Comments on Request for Information to Barriers and Competition

On January 25, the Arthritis Foundation submitted comments in response to a request for information from the Department of Health and Human Services regarding choice and competition in Medicare, Medicaid, and the marketplaces. The comments highlighted concerns about the direction of the health care regulations, and the need to preserve important patient protections under current law, and the potential for erosion of network adequacy standards. Read the letter here.

January 19, 2018

Arthritis Foundation Joins 31 Organizations to Urge CMS to Suspend Application of Therapy Cap Policy

On January 19, the Arthritis Foundation joined dozens of organizations calling for the Centers for Medicare and Medicaid Services (CMS) to suspend the application of the Medicare therapy cap policy. Beginning on January 1, 2018, there is a limit on the amount of outpatient rehabilitation services that the Medicare program will cover. Physical and occupational therapy plays an important role in the treatment of arthritis by improving mobility and restoring the use of affected joints, increasing strength to support the joints, and maintaining fitness and the ability to perform daily activities. Read the letter here.

January 17, 2018

Arthritis Foundation Applauds Consensus Statement on Improving Prior Authorization Process

On January 17, six organizations representing health care providers and health plans released a consensus statement to find opportunities to improve prior authorization programs. The Arthritis Foundation applauds the consensus statement, which follows a separate publication of 21 prior authorization and utilization management reform principles in 2017. The Arthritis Foundation was the only patient organization to participate in the development of these principles last year. The principles strongly urge health plans and benefit managers to apply the principles to utilization management programs for pharmacy and medical benefits. Read the principles here.

January 16, 2018

Arthritis Foundation Signs Coalition Letter Addressing Medicare Advantage and Part D Proposed Rule

On January 16, the Arthritis Foundation joined nearly three dozen organizations from MAPRx, a national coalition of beneficiary, caregiver and health care professional groups, to submit public comments on a proposed rule affecting Medicare Advantage and Medicare Part D. The letter emphasized the need to balance prescription drug plan flexibility with protections for Medicare enrollees. Read the letter here.

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