Chris Hansen, ACS CAN President

ACS CAN President Lisa Lacasse shares her views on the impact of advocacy on the cancer fight.

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Joining Together to Protect Access to Treatment in Medicare

March 27, 2019

ACS CAN is once again uniting with other patient and provider organizations, this time to voice our opposition to proposed changes to Medicare Part D’s six protected classes policy, which could hinder patients’ timely access to lifesaving therapies. This Thursday, dozens of patients, providers and caregivers will meet on Capitol Hill to ask lawmakers to oppose the proposed changes to Medicare Part D prescription drug benefit. Together we represent millions of Americans affected by cancer, epilepsy, HIV/AIDS, mental illness and organ transplants, whose access to critical drugs could be restricted if the proposed changes are implemented.

Currently, Medicare Part D plan sponsors are required to cover substantially all drug therapies in the designated six protected classes as soon as they are approved by the FDA. The proposed changes would allow Part D plans greater use of utilization management tools (step therapy and prior authorization) on beneficiaries who are already on stabilized drug treatments and delay access to the most clinically appropriate treatments. This policy would limit access to these protected class drug therapies, which could potentially interrupt patients’ ability to manage their disease.

More than 50 advocates from 23 different patient groups will participate in the lobby day this week on Capitol Hill, among them 16 ACS CAN volunteers. In addition to meeting with lawmakers, ACS CAN will release the results of a new nationwide survey showing how utilization management policies have negatively affected patient care in private insurance and what that could mean for those who receive health coverage through Medicare, should the proposed changes go into effect.

Since the Department of Health and Human Services (HHS) released its proposed changes to Medicare Part D drug coverage in November 2018, ACS CAN has led efforts to voice the patient community’s significant opposition to the proposal. Earlier this year, we launched a new print and digital ad campaign to call directly on Congress and HHS Secretary Alex Azar to stop the proposed changes to Medicare Part D. Nearly 60 patient and provider organizations joined the campaign, signaling the widespread opposition to proposed policy changes that pose significant risk to patients with serious medical conditions.

Additionally, ACS CAN joined patient advocacy groups in sending a comment letter to HHS detailing how the proposed changes could jeopardize timely access to drug therapies for patients with serious and chronic health conditions by restricting or delaying access to the most clinically appropriate treatments.

As part of the ongoing campaign to stop this rule, ACS CAN participated in a joint day of action on Twitter. Using the hashtag, #DontDelayAccess, our volunteers tweeted at Secretary Azar to voice our concerns about the proposed policy changes.

ACS CAN prioritizes ensuring cancer patients have timely access to potentially lifesaving drug therapies. We look forward to meeting with Members of Congress on Thursday and urging them to oppose HHS’s proposal to change Medicare Part D’s six protected classes drug coverage policy.