Help Pass HB 2708 to Cap Costs for West Virginians with Diabetes
In 2020, the West Virginia legislature passed a private insurance insulin copayment cap of $100 per month.
This year the West Virginia legislature can do even better.
Let’s get HB2708 moving!
We need your help!
HB 2708 will cap per month copayments in private insurance:
- $25 for insulin
- $25 for other diabetes-related drugs
- $100 for all diabetes-related medical supplies and equipment
Connect With Your Legislators!
HB 2708 is currently assigned first to the Health and Human Resources Committee and then to the Finance Committee. HB 2708 must be voted on and pass both Committees by March 28 or the bill dies for this year.
NIMHD Director’s Seminar Series Features L. Ebony Boulware, M.D., M.P.H on February 4 at 2:00 p.m.
Attend the NIMHD Director’s Seminar Series Lecture featuring L. Ebony Boulware, M.D., M.P.H., on Thursday, February 4 at 2:00 p.m. She will discuss “Where the Cloud Meets the Ground: Democratizing Health Data to Improve Community Health Equity.”
Dr. Boulware is the Chief of the Division of General Internal Medicine and the Director of the Duke Clinical and Translational Science Institute. She has devoted her scholarly career to studying mechanisms to improve the quality and equity of health care and health outcomes for patients and populations with chronic diseases, such as chronic kidney disease and hypertension. Her work investigates the influence of attitudinal, social, and environmental contexts on health and health outcomes. Dr. Boulware has published more than 150 manuscripts and has mentored numerous students, fellows, and faculty members in clinical research. She frequently engages with community members, patients, and their families, and other stakeholders, to develop and implement relevant and sustainable interventions for health improvement.
This lecture will be held virtually, is open to the public, and can be viewed through the NIH videocast system at https://videocast.nih.gov.
Questions prior to and during the seminar can be submitted to NIMHDDSS@mail.nih.gov.
CMS Announces New Guidance for Safe Visitation in Nursing Homes During COVID-19 Public Health Emergency
On September 17, CMS issued revised guidance providing detailed recommendations on ways nursing homes can safely facilitate visitation during the coronavirus disease 2019 (COVID-19) pandemic. After several months of visitor restrictions designed to slow the spread of COVID-19, CMS recognizes that physical separation from family and other loved ones has taken a significant toll on nursing home residents. In light of this, and in combination with increasingly available data to guide policy development, CMS is issuing revised guidance to help nursing homes facilitate visitation in both indoor and outdoor settings and in compassionate care situations. The guidance also outlines certain core principles and best practices to reduce the risk of COVID-19 transmission to adhere to during visitations.
See the full text of this excerpted CMS Press Release (issued September 17).
CMS Announces Transformative New Model of Care for Medicare Beneficiaries with Chronic Kidney Disease
Model focuses on reducing costs and improving quality of care for patients
On September 18, CMS announced it has finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model, to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on President Trump’s Advancing Kidney Health Executive Order and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years.
“Over the past year, the Trump Administration has taken more action to advance American kidney health than we’ve seen in decades,” said HHS Secretary Alex Azar. “This new payment model helps address a broken set of incentives that have prevented far too many Americans from benefiting from enjoying the better lives that could come with more convenient dialysis options or the possibility of a transplant.”
For More Information:
CMS Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients
Radiation Oncology Model will modernize Medicare payments for radiotherapy services
On September 18, CMS finalized a new Innovation Center model expected to improve the quality of care for cancer patients receiving radiotherapy and reduce Medicare expenditures through bundled payments that allow providers to focus on delivering high-quality treatments. The new Radiation Oncology (RO) Model allows this focus on value-based care by creating simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. The RO Model, part of a final rule on specialty care models issued by CMS, will begin on January 1, 2021 and is estimated to save Medicare $230 million over 5 years.
“President Trump knows that, for cancer patients, what matters is their quality of life and beating their cancer. But today, Medicare payment for radiotherapy is based on the number of treatments a patient receives and where they receive it, which can lead to spending more time traveling for treatment with little clinical value,” said CMS Administrator Seema Verma. “That’s why the Trump administration has developed a new innovative model that allows patients and providers to focus on better outcomes for patients.”
For More information:
These Models are a part of a CMS final rule on Medicare Program; Specialty Care Models To Improve Quality of Care and Reduce Expenditures (CMS-5527-F).
The Centers for Disease Control and Prevention (CDC), located within the Department of Health and Human Services (HHS), has announced an opportunity to hear stakeholders’ perspectives on and experiences with pain and pain management, including but not limited to the benefits and harms of opioid use. These stakeholders include patients with acute or chronic pain, patients’ family members and/or caregivers, and healthcare providers who care for patients with pain or conditions that can complicate pain management (e.g., opioid use disorder or overdose). As part of this effort, CDC will be holding approximately 100 individual conversations with stakeholders over the phone or through an internet-enabled virtual platform. Persons interested in participating should contact CDC no later than 5:00 p.m. EDT August 21, 2020.
Contact information and additional detail is located here:
On Friday, President Donald Trump took historic action to deliver lower prescription drug prices to American patients. The President signed four Executive Orders on drug pricing directing the Secretary of Health and Human Services (HHS) to take several steps to deliver for American patients lower costs on prescription drugs, including insulin and epinephrine, and ensure Americans are getting the lowest price possible for their drugs.
The executive orders instruct HHS to take a number of actions:
- End a shadowy system of kickbacks by middlemen that lurks behind the high out-of-pocket costs many Americans face at the pharmacy counter. Under this action, American seniors will directly receive these kickback as discounts in Medicare Part D. In 2018, these Part D discounts totaled more than $30 billion, representing an average discount of 26 to 30 percent.
- Require federally qualified health centers who purchase insulin’s and epinephrine in the 340B program to pass the savings from discounted drug prices directly on to medically underserved patients. This will increase access to life-saving insulin and epinephrine for the patients who face especially high costs among the 28 million patients who visit FQHCs every year, over six million of whom are uninsured.
- Finalize a rule allowing states to develop safe importation plans for certain prescription drugs.
- Authorize the re-importation of insulin products made in the United States if the Secretary finds re-importation is required for emergency medical care pursuant to section 801(d) of the Food, Drug, and Cosmetic Act.
- Create a pathway for safe personal importation through the use of individual waivers to purchase drugs at lower cost from pre-authorized U.S. pharmacies.
- Take action to ensure that the Medicare program and seniors pay no more for the most costly Medicare Part B drugs than any economically comparable OECD country, ending foreign countries’ free loading off the backs of American taxpayers and pharmaceutical investments. This order takes effect in 30 days unless Congress acts.
“President Trump has already done more than any other President to lower drug costs,” said HHS Secretary Alex Azar. “No President has ever taken action on drug prices as bold as any one of today’s individual actions. Today’s executive orders will deliver billions of dollars in discounts directly to patients at the pharmacy counter, safe low-cost imported drugs for Americans, the best deals for America on highly expensive drugs, and direct discounts passed on to patients on important drugs from community health centers. The President’s new efforts to cut drug costs are about making it affordable for American patients to be in control of their own health, their own healthcare choices, and the care they decide on with their own doctor.”
Link to Link to Executive Orders
White House fact sheet