Amendment to Section 1927 of the SSA Act regarding Medicaid Payments for Covered Outpatient Drugs
A Federal Legislative Solution to Improving Medicaid Coverage of Rare Disease Therapies
Jay Greissing Dir., U.S. Gov’t Relations and Public Policy
We enable people with life-altering conditions to lead better lives.
September 19, 2014
Medicaid Coverage Restrictions Step Therapy
• • • • •
Alaska Arkansas California Georgia Minnesota
• Oregon – Section 1115 Waiver to establish Prioritized Health Services List To be as brave as the people we help.
• Prohibit Medicaid plans from using restrictive step therapy protocols when: • The drug is prescribed for a rare disease; and • The rare disease is an FDA approved use To be as brave as the people we help.
Why Should The Community Partner to Petition Congress?
quity for individuals w/ rare conditions •
hysician and patient preference •
nnovation of and access to individualized treatments •
ontinuity of care To be as brave as the people we help.