Medicaid

Questions for Mehmet Oz, M.D. for his nomination to lead CMS

As the Committee considers the nomination of Mehmet C. Oz, M.D. to serve as CMS Administrator, the HIV+Hepatitis Policy Institute urges you to ensure the nominee will uphold a stalwart commitment to a comprehensive healthcare system that includes a robust private insurance market, along with strong Medicaid and Medicare programs. All are critical to making American healthier again and in ending the chronic diseases of HIV and hepatitis. Please find attached suggested questions for Dr. Oz concerning 1) a federal court decision regarding copay assistance for prescription drugs, 2) preventive services coverage under the ACA, 3) private insurance prescription drug coverage and affordability policies, and 4) the Medicare Part D six protected classes of prescription drugs.

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Maryland Senate testimony in opposition to SB357 to expand the PDAB’s authority

While we all want to lower drug costs, we do not believe that expanding the PDAB’s Upper Payment Limit (UPL) authority will actually save patients money. Instead, we have significant concerns that SB 357 could unintentionally restrict access to critical medications, discourage investment in new treatments, and reduce funding to safety net programs that already help patients afford life-saving drugs.

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Comments on updated HIV & hepatitis strategic plans

As a policy and advocacy organization we work to ensure there are the proper policies, programs, and funding to implement the Strategic Plans. We also refer to them in our work with the Congress, media, and the public to help educate them on the strategic plans and national goals included in each of the plans. We use them to measure our progress in meeting the goals. We not only use them to advocate before the Congress but also within government agencies and leadership to hold them accountable to ensure the goals are reached and that proper policies and programs are in place with sufficient funding.

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Comments to Washington Prescription Drug Affordability Board on HIV treatment and cost of care

While patients currently have access to free or affordable HIV medications through various avenues, we are concerned that setting an arbitrarily low price for these treatments could negatively impact future drug development and reduce manufacturers’ willingness to continue providing medications to millions of people in underdeveloped and underserved nations. It is essential that manufacturers have the necessary incentives to invest in research and development, enabling the creation of longer-acting treatments, preventive drugs, vaccines, and potentially even a cure for the virus. Overlooking the impact of current assistance programs on HIV treatment affordability, as well as mandating alternative drug options, disregards the nuances of HIV care and the unique requirements of each patient.

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Letter on MassHealth coverage of long-acting injectable PrEP

A number of Massachusetts-based providers, community-based organizations and clinical sites joined us in writing to you in August 2022 to express our concern that MassHealth had not yet added cabotegravir, a new long-acting injectable form of pre-exposure prophylaxis (PrEP) to prevent HIV, to its formulary, and to urge MassHealth to make sure it is available without any barriers to access, such as utilization management or prior authorization requirements. (A copy of the August letter is attached.)

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