Advocacy News & Regulatory Letters
June 13, 2019
Arthritis Foundation Supports Bipartisan Prior Authorization Reform Legislation
The Arthritis Foundation applauded the introduction of bipartisan legislation intended to improve transparency of prior authorization use and oversight in Medicare Advantage plans. The Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107) would establish a process for “real time” decision-making for services that are routinely approved and require plans to offer an electronic prior authorization process. Read more here.
April 8, 2019
Patient and Provider Organizations Urge Step Therapy Safeguards for Beneficiaries Enrolled in Medicare Advantage
On April 8, the Arthritis Foundation joined over two dozen patient and provider organizations to urge the federal Department of Health and Human Services to implemented patient guardrails for 2019 enrollees in Medicare Advantage, the private insurance alternative to traditional Medicare. Last fall, the administration released guidance to Medicare Advantage plans that granted them permission to use step therapy. Read the letter here.
April 8, 2019
Arthritis Foundation Joins 32 Organizations in Support of Legislation to Rollback Short-Term Health Plans
On April 8, nearly three dozen organizations submitted a statement for the record to the House Committee on Education and Labor in support of legislation that would invalidate a federal regulation that recently expanded short-term health plans. Short-term health plans are not required to comply with protections for people with pre-existing conditions like arthritis. Read the statement here.
April 5, 2019
Arthritis Foundation Comments on Proposal to Eliminate Rebates from Medicare Part D and Medicaid
On April 5, the Arthritis Foundation submitted comments on a federal proposal that would replace the existing drug rebate system with discounts to consumers at the pharmacy counter. Today, rebates that pharmaceutical companies offer health plans are usually not passed on to patients. The Arthritis Foundation supported the broader goals of the proposal but expressed concern about how changes to the manufacturer rebate system would be implemented. Read the letter here.
April 1, 2019
Arthritis Foundation Continues to Engage with the Administration on Pain Management Issues
On April 1, the Arthritis Foundation submitted comments to the Department of Health and Human Services on their Draft Pain Management Best Practices Guidelines, highlighting the unique perspective of people with arthritis and the need for strong patient education and access to resources on pain management. Click here to read to comments.
Surprise Billing Issue Brief
Surprise billing occurs when a healthcare provider bills a patient for the difference (or balance) between the provider’s charge for the service and the health plan’s payment for that service. Patients often receive these types of bills when they receive care from an out-of-network provider. Read more about the issue and potential solutions here.
Arthritis Foundation Leads the Way in Building Support for Federal Investments in Arthritis Research and Programs
Throughout the month of March, the Arthritis Foundation sent sign-on letters to the Appropriations Committees on the CDC Arthritis Program, arthritis research at the Department of Defense, and the National Institute of Musculoskeletal and Skin Diseases, with more than a dozen organizations joining the way.
February 19, 2019
Arthritis Foundation Comments on Annual Notice of Benefit and Payment Parameters
On February 19, the Arthritis Foundation submitted comments to the Department of Health and Human Services (HHS) on the proposed Notice of Benefit and Payment Parameters for 2019. The proposed regulation affects the individual health insurance market and the health care exchanges. Our comments focused on proposed increases in premiums and out-of-pocket costs as well as impacts on access to needed medications for people with arthritis. Read the letter here.
February 7, 2019
Arthritis Foundation Submits Comments on Medicaid Waiver from Tennessee
The Arthritis Foundation submitted comments to the federal Department of Health and Human Services on the state of Tennessee’s 1115 Medicaid waiver. The waiver seeks to add a work and community engagement component to the state’s Medicaid program. The proposal would require enrollees to report at least 80 hours of work per month, or that they meet certain exemptions under the proposal. A major consequence is that administrative burdens would increase for enrollees, and implementing this proposal would be expensive for the state. Read the letter here.
February 1, 2019
Arthritis Foundation Joins Over 70 Organizations Urging Reauthorization of the Pediatric Subspecialty Loan Repayment Program
On February 1, several dozen organizations dedicated to improving the health and wellbeing of children and adolescents wrote leaders in Congress to reauthorize a federal loan repayment program that supports pediatric subspecialists. The program provides loan repayment for physicians who specialize in pediatrics – such as pediatric rheumatology – if they commit to working in an underserved area of the country for a period of time. Read the letter here.
January 29, 2019
Arthritis Foundation and American College of Rheumatology to Hold Briefing on Arthritis in the Military
On February 13, the Arthritis Foundation and American College of Rheumatology will hold a briefing on Capitol Hill to highlight the epidemic of arthritis among U.S. military service members and veterans. Read more here.
January 24, 2019
Arthritis Foundation Comments on Medicare Advantage and Part D Proposed Rule
On January 24, the Arthritis Foundation submitted comments to the Centers for Medicare and Medicaid Services on a proposed regulation affecting Medicare Advantage and Medicare Part D, the prescription drug program. The Foundation’s comments highlighted concerns with last fall’s guidance that permits step therapy in Medicare Advantage plans. We also applauded the administration’s action to address pharmacy gag clauses, which prevent pharmacists from telling patients when it might be cheaper to pay for medication with cash rather than through insurance. Read the comments here.
January 18, 2019
Arthritis Foundation Comments on Medicaid Waiver from Oklahoma
The Arthritis Foundation submitted comments to the federal Department of Health and Human Services on the state of Oklahoma’s 1115 Medicaid waiver. The waiver seeks to add a work requirement to the state’s Medicaid program. A major consequence of the proposal is that it will increase the administrative burden on all patients, including those with chronic diseases like arthritis who depend on Medicaid for health care. Read the letter here.
January 4, 2019
Arthritis Foundation Comments on Medicaid Waiver from Virginia
The Arthritis Foundation submitted comments to the federal Department of Health and Human Services on the state of Virginia’s 1115 Medicaid wavier. The waiver seeks to add a work and community engagement component to the state’s Medicaid 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 2, 2019
Arthritis Foundation Comments on Medicare IPI Model
The Arthritis Foundation submitted comments to the federal Department of Health and Human Services on a proposal that would change how physician-administered drugs are paid for under the Medicare program. As described in the proposal, we believe the international pricing index (IPI) model’s projected benefits are outweighed by potential negative impacts on patient access. Read the letter here.
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