A CRITICAL ALERT FROM CCDC! Protect Access to Essential Medications for People with Disabilities!
02/21/2014 (All day) - 03/07/2014 (All day)
A CRITICAL POLICY CHANGE THAT COULD AFFECT MEDICATIONS FOR PEOPLE WITH MEDICARE, DUAL ELIGIBLES, PEOPLE WITH MENTAL HEALTH NEEDS, INDIVIDUALS WITH CANCER, HIV, AIDS, SENIORS AND MANY MORE!
PLEASE Oppose Regulatory Language from CMS That Will Restrict Access to Important Medications for People with Developmental Disabilities Who Receive Medicaid and Medicare (the Dual Eligibles).
The Centers for Medicare and Medicaid Services (CMS) is proposing to revise the long standing policy that requires Medicare Part D prescription drug plans to include on their formularies (the list of drugs covered by the plan) "all or substantially all" drugs within six classes:
* Antidepressants (e.g., Prozac, Effexor, Zoloft) used for treating depression,
* Antipsychotics (e.g., Risperdal, Zyprexa, Seroquel) used for treating psychiatric disorders such as schizophrenia and bipolar disorder
* Anticonvulsants (e.g., Depakote, Tegretol, Lamictal) used for preventing or reducing seizures,
* Immunosuppressants used to prevent the rejection of transplants,
* Antiretrovirals used in the treatment of HIV and AIDS, and
* Antineoplastics used to treat cancers.
This policy, known as the "six protected classes" policy, is an important consumer protection that has been in effect since the roll out of Part D. People who are Medicare beneficiaries or are dually eligible for Medicare and Medicaid receive their prescription drug coverage through Medicare Part D.
CMS is proposing that antidepressants and immunosuppresants lose protected status in 2015 and anti-psychotic medications in 2016. This would likely mean that Medicare Part D prescription drug plans would not continue to cover all or substantially all of the drugs in these medication classes. People who require medication not on the drug plan's list would have to either:
1. Pay out of pocket;
2. Change to a potentially less effective medication or a medication that may have additional side effects; or
3. Utilize the exceptions or appeals process to try to gain access to the drug (with no assurance that this process would be successful).
Prescription Medications - Particularly in the medication classes described in this Action Alert - are not interchangeable, and doctors prescribe treatments to meet the unique needs of each person. When the Medicare Part D program was initiated, these classes of drugs were protected because of concerns that Part D formularies would be restrictive and limit access to medications. CMS is proposing these changes to save money. However, it is highly likely that disrupting access to needed medications will be a threat to the person's health and well-being and may lead to increased Medicare expenditures by resulting in more doctor visits, hospital emergency room visits, and hospitalizations.
What You Can Do:
Advocates and families must write COMMENTS to CMS.
In the comments section PLEASE SAY:
Drop the language making changes to the antidepressant, antipsychotic, and immunosuppressant medication classes!
PLEASE ADD ANY INFORMATION THAT YOU SEE FIT TO PROTECT YOUR ACCESS TO ESSENTIAL MEDICATIONS!
Comments are due no later than March 7th.
To provide comments electronically:
* Go to www.regulations.gov and in the search box enter RIN 0938-AR37.
* Click the "comment now" button next to the regulation called "Medicare Program: Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs."
CHECK THE WEBSITE FOR ALTERNATIVE METHODS FOR COMMENT OR SEND BY MAIL WELL BEFORE MARCH 7TH TO:
Centers for Medicare&Medicaid Services,
Department of Health and Human Services, Attention: CMS-4159-P,
P.O. Box 8013,
Baltimore, MD 21244-8013.
Please allow sufficient time for mailed comments to be received before the close of the comment period.