Between 2017 and 2019, 10,000 bills were passed by Congress and 443 of them were signed into law by the president (FN). Each bill has the potential to directly impact people living in vulnerable, underserved communities, affected by chronic conditions. CCPA is compelled to ensure that proposed new laws create public policy that improves the lives of those living with chronic conditions and diseases.
Federal Public Policy Priorities
Joint sign on letter, Rx pricing reform
Prescription drug pricing reform proposals in the Senate’s reconciliation package became serious concern. The proposed legislation failed to help all Medicare beneficiaries, it can put future treatment advances at risk, and it failed to address significant cost-drivers in the marketplace that leads to patients experiencing high out of pocket costs and difficulty accessing care. We asked other patient, advocacy, and healthcare organizations to join us in calling on Congress to revise the policies to focus on reducing out-of-pocket costs and protecting access to treatment for patients. See our letter: https://chroniccarealliance.org/letter-to-congress-drug-pricing-reform-should-protect-patients/
340 B Drug Pricing Program
Created in 1992, the 340B Drug Pricing Program was designed to expand access to affordable, discounted prescription medications for vulnerable, low-income, and uninsured patient populations. Over time, the 340B program has grown immensely to become the second largest federal prescription drug program in the country behind Medicare Part D. But the facts today suggest 340B has evolved beyond its original intent to better serve qualifying hospitals and pharmacies that provide these discounted drugs, rather than the vulnerable patient populations who need them, including many individuals with chronic conditions that CCPA advocates for every day. CCPA is actively working to educate and raise the awareness of the public, policymakers, and elected officials on this subject. See our blog with more information on the 340B program: https://chroniccarealliance.org/what-you-need-to-know-about-the-340b-drug-pricing-program/
HR 7213 Equitable Community Access to Pharmacist Services Act
Pharmacists have been a huge asset to the public during the pandemic. HR 7213, the Equitable Community Access to Pharmacist Services Act, would extend the permissions granted to pharmacists work in areas they are already licensed for but had been previously unable to use and authorize reimbursement for these services. Pharmacists are among the most accessible health care professionals, with nine in ten Americans living within five miles of a pharmacy. Pharmacists fill a need for providers in rural and underserved areas and for patients who receive vaccines and assistance managing their overall health during pharmacies’ flexible hours, including during the weekend and holidays when most doctors’ offices are closed. CCPA supports and helped raise awareness for HR 7213.
Pharmacy Benefit Managers (PBM) Concerns
On June 7 2022, the Federal Trade Commission (FTC) announced it would launch an inquiry into the prescription drug middleman industry, (PBMs) following a public comment period which was successful in bringing about greater discussion about the role of these middlemen. This inquiry is just one mechanism through which the Biden Administration can work on behalf of patients to rein in these predatory practices. You can read more on CCPA’s concerns about PBM practices here: https://chroniccarealliance.org/patient-access-and-the-role-of-pharmacy-benefit-managers-pbms-in-the-health-care-system/
Comprehensive Medication Management
The GTMRx Institute is a catalyst for change that brings together critical stakeholders, bound by the urgent need to get the medications right. We are physicians, pharmacists, caregivers, health IT innovators, drug and diagnostics companies, consumer groups, employers, payers and health systems, aligned to save lives and save money by advancing adoption of a systematic approach to medication use, enabled by technology, through comprehensive medication management, or CMM. CCPA is an executive member of the Institute.
Prescription Drugs Standards – API Interoperability and Transparency
Patients and the health care providers caring for them are often presented with an incomplete picture of their health and care as pieces of their information are stored in various, unconnected systems and do not accompany the patient to every care setting. Although more than 95% of hospitals and 75% of office-based clinicians are utilizing certified health IT, challenges remain in creating a comprehensive, longitudinal view of a patient’s health history. Additional Background on APIs and Recent Centers for Medicare and Medicaid Services Regulations Requiring Use of API Technology by Health Plans
On March 9, 2020, the Centers for Medicare and Medicaid Services (CMS) issued the final rule on interoperability and patient access; Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities. The CMS policy focuses on interoperability reforms which could facilitate care and coverage coordination by improving information access. The intent of the CMS policy is to move the health care ecosystem in the direction of interoperability, and to signal a commitment to the vision set out in the 21st Century Cures Act and Executive Order 13813 to improve quality and accessibility of information that Americans need to make informed health care decisions. including data about health care prices and outcomes, while minimizing reporting burdens on affected health care providers and payers.