Aimed Monthly
This issue of Aimed Monthly includes two new resources on non-medical switching for persons with mental health conditions, our amicus brief, a new federal law, and much more.
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Aimed Alliance Releases Mental Health and Non-Medical Switching Fact Sheet
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Aimed Alliance Submits Amicus Brief in Lawsuit to Enjoin Non-EHB Program
On August 16, Aimed Alliance, along with six other patient advocacy organizations, requested permission from the United States District Court for the District of New Jersey to file an amicus brief on the impacts of non-EHB programs like SaveOnSP’s. The amicus brief addresses how SaveOnSP’s conduct deceives, influences, and harms consumers, and how SaveOnSP’s conduct creates implications for national health policy. Aimed Alliance’s fellow “friends of the court” are Triage Cancer, the HIV+Hepatitis Policy Institute, the Coalition of State Rheumatology Organizations, The AIDS Institute, the National Oncology State Network, and the Connecticut Oncology Association. Read the Amicus Brief here. To learn more about non-EHB programs, read our fact sheet.
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Patient Advocacy Groups File Lawsuit Against Federal Copay Accumulator Rule
On August 30, the HIV+Hepatitis Policy Institute, the Diabetes Patient Advocacy Coalition, and the Diabetes Leadership Council filed a lawsuit against the Department of Health and Human Services (HHS) arguing that HHS’s 2021 Notice of Payment and Benefit Parameters (NBPP) which permitted insurers to adopt their own definition of “cost-sharing” thereby allowing plans to implement copay accumulator programs, was inconsistent with existing regulations, and arbitrary and capricious. Thus, the complaint asks the Court to hold that the 2021 NBPP approval of copay accumulator programs is unlawful. Read the complaint here.
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Aimed Alliance Publishes Cannabinoid Fact Seet
CBD, delta-8-THC, and other cannabinoid products are widely advertised and available. Some are marketed with unproven medical claims, while others are promoted for their intoxicating effects. To help consumers make informed decisions, Aimed Alliance published "Cannabinoids: A Fact Sheet for Consumers." This new resource defines cannabinoids and discusses their legal status and potential health effects. Read the fact sheet here.
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AfPA Releases New Video on Non-Medical Switching
The Alliance for Patient Access (AfPA) recently released a new video on non-medical switching titled “The Real Price of Non-Medical Switching”. The video reviews the importance of patients with mental health conditions having stable access to their treatments and how non-medical switching can interfere with this access. Watch the video here.
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Upcoming Webinar on a Balanced Approach for Telehealth
On September 13, 2022 from 2PM-3PM ET the Patient Advocacy Leaders United for Movement Disorders will be hosting a webinar on “Trends & Issues in Telehealth – Advocating for a Balanced, Patient-Centered Approach.” The webinar will bring together advocates from the movement disorder community to address some of the concerns associated with telehealth usage. The speakers will discuss how to respond with collaborative education and advocacy initiatives. Register for the webinar here.
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President Biden Signs Inflation Reduction Act
On August 16, President Biden signed the Inflation Reduction Act (IRA) into law. The IRA allows the Secretary of Health and Human Services (HHS) to negotiate Medicare drug prices for certain single-source drugs; requires pharmaceutical manufacturers to pay a rebate if their prices increase faster than inflation; and provides a $35 out-of-pocket cap on insulin for Medicare beneficiaries. Learn more about the IRA’s health care provisions here
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New Insurance Pricing Transparency Requirements Could Help Patients and Employers Save Money
On July 1, the first phase of the Transparency in Coverage Final Rule, issued by the Centers for Medicare and Medicaid Services (CMS), went into effect. This phase requires employers and health insurers to publish their negotiated rates with hospitals and the amounts paid to out-of-network providers. This rule is intended to increase transparency within the healthcare system and to help enable enrollees and employers to make informed decisions regarding health insurance. Advocates are concerned that insurers may not comply with these reporting requirements and are, therefore, calling on CMS to develop an enforcement strategy. Read more about the Transparency in Coverage Final Rule here.
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While many state legislature sessions have ended for 2022, Aimed Alliance is still tracking several key bills that are still active.
Copay Accumulators
District of Columbia: B24-0557 – Introduced
Delaware: SB 267 – Passed and sent to Governor
New York: S 5299A/A 1741A – Passed not yet sent to Governor
Ohio: HB 135 – Referred to Senate Committee on Health
Pennsylvania: SB 196/HB 1664 – Currently in House Insurance Committee and Senate Banking and Insurance Committee
Step Therapy & Prior Authorization
California: AB 1880 – Passed
Non-Medical Switching
Pennsylvania: HB 599 – Currently in the House Insurance Committee
White Bagging
California – SB 958 – Passed Senate, currently in House Committee on Health
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Aimed Alliance Releases Non-EHB Fact Sheet
Aimed Alliance published a fact sheet titled “How A Loophole in the Patient Protection and Affordable Care Act Can Impact Access To Your Necessary Treatments.” This resource explains how some health plans define specialty medications as non-essential health benefits under the ACA, and how state and federal legislation can help close the EHB loophole. Read the new fact sheet here.
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