Arthritis Foundation Legislative Position Statements

Position Statements

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Step Therapy

More and more insurers require patients to try and fail one or more covered medications before providing the prescribed medication. We support legislation that addresses burdensome use of step therapy, which can restrict access to needed therapies.

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Prior Authorization

Some insurance companies require a lengthy process before dispensing specialty drugs, which causes unnecessary delays. We support legislation to streamline prior authorization protocols to limit lengthy delays and frustrations for doctors, patients, and pharmacies.

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Out-Of-Pocket Costs

Many people with arthritis also suffer from other chronic diseases and monthly medication costs can include several kinds of medications, often at specialty tier cost. We support legislation that tackles high out-of-pocket costs for specialty medications.

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Mid-Year Formulary Changes

We support legislation that prohibits inappropriate formulary changes, which can negatively impact a stable patient's ability to remain on effective therapy.

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We support legislation that ensures patients and providers are notified when an interchangeable biosimilar substitution is made.

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Insurance Plan Transparency

We support legislation that provides formulary transparency in health insurance plans.

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Network Adequacy

We support legislation that ensures patients have access to adequate networks of providers.

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Health System Transparency

We support legislation that will result in system-wide transparency, patient representation in decision-making processes, and collaboration in finding shared solutions.

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Market Stabilization

More must be done to protect people with pre-existing conditions like arthritis in the individual insurance market. We support increased transparency for short-term plans and association health plans, a healthy risk pool, and the introduction of reinsurance programs to help insurers cover claims for high-cost patients.