Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts
Wednesday, October 1, 2014
Medicaid: States Cannot 'Delay or Deny' Autism Treatment
http://www.autismspeaks.org/advocacy/advocacy-news/medicaid-states-cannot-delay-or-deny-autism-treatment
Thursday, February 27, 2014
Document: Oppose Language from CMS That Will Restrict Access to Important Medications for People with Disabilities
To families of individuals with developmental disabilities:
The Centers for Medicaid and Medicare want to change a policy that requires that Medicare Part D Prescription plans include all medications in six protected groups. These medication groups are protected for a reason. They are vital to individuals who need them. This will have a significant impact on individuals with developmental disabilities who receive both Medicare and Medicaid. The policy change applies to several of the groups of medications, and could signal the beginning of removing protections for all six groups of medications in the future. These groups of medications are for things like cancer, seizure medications, psychiatric drugs and HIV. Your family member may not have Medicare yet, but at some point in their lives, they may become dually eligible. Please consider protecting their future access to these medications and access for those now eligible by responding to The Arc's action alert below.
Karen Scallan
Parent Advocate
Special Needs and Parent Support Services of LA, LLC
Email: kcscallan@gmail.com
Twitter: @KarenScallan
Blog: http://parentperspectivesonmltss.wordpress.com
Oppose Language from CMS That Will Restrict Access to Important Medications for People with Disabilities
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)
Background:
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.
Impact:
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:
- pay out of pocket;
- change to a potentially less effective medication or a medication that may have additional side effects; or
- 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 to CMS and urge them to drop the language making changes to the antidepressant, antipsychotic, and immunosuppressant medication classes. Comments are due no later than March 7th. To provide comments electronically:
Document: Oppose Language from CMS That Will Restrict Access to Important Medications for People with Disabilities
"Life on the Autism Spectrum can be ENJOYable."
Thursday, June 28, 2012
The Arc Reacts to the U.S. Supreme Court’s Decision on the Affordable Care Act
The Arc | For People with Intellectual and Developmental Disabilities
“People with intellectual and developmental
disabilities have been waiting for generations for the insurance reforms put in
place by the Affordable Care Act. Today’s ruling removes any doubts that the law
Congress enacted should stand and will benefit millions of people with and
without disabilities. It ends discriminatory insurance practices and makes
health coverage more affordable and accessible – important protections which too
many people with disabilities have been deprived of for too
long.
“But the ruling is not perfect for people with I/DD.
Read the full response by Marty Ford, Director of Public Policy for The Arc
Washington, DC – The Arc released the following statement in response to the U.S. Supreme Court’s decision to uphold the Affordable Care Act
Posted on
.
The Arc Reacts to the U.S. Supreme Court’s Decision on the Affordable Care Act | The Arc Blog
via
Autism Speaks Response to U.S. Supreme Court Ruling on the Affordable Care Act
'Enjoying The Hi-5s of Autism - A Family Experience' at 'Enjoying The Hi-5's of Autism - A Family Experience' - 11 minutes ago
"The need for people with autism to get good quality care is Autism Speaks' first priority. Today's decision by the U.S. Supreme Court upholding the constitutionality of the Affordable Care Act provides clarity to our efforts to achieve that mission. It should be noted that the decision does not affect the autism insurance reform laws enacted by 31 states. ... Congress required such treatment be included as an essential health benefit and the U.S. Supreme Court has held the act constitutional. It is now the obligation of HHS to respect the intent of Congress by insisting all states ... more »
More information on The Affordable Care Act
House Judiciary Subcommittee on the Constitution Holds Hearing on Son-of-the-ADA-Notification Act
Sam at Disability Law - (june 28, 2012)
Yesterday, the Subcommittee on the Constitution of the House Judiciary Committee held a hearing on H.R. 3356, the "ACCESS (ADA Compliance for Customer Entry to Stores and Services) Act," which is the latest version of the oft-proposed ADA Notification Act. The bill's sponsor, Rep. Lungren, testified, as did business owner Lee Ky, disability rights lawyer Andy Levy, and defense lawyer David Warren Peters. You can find their written testimony, as well as the video of the hearing, at the link above.
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