32 Organizations Oppose Changes to Six Protected Classes
March 3, 2021
March 3, 2021
Dear Members of the California Congressional Delegation:
As California’s leading patient advocates and community health stakeholders, we were dismayed to learn of recent actions designed to “modernize” the Medicare Part D Program.
Earlier this year, the previous administration’s Department of Health and Human Services (HHS) enacted a dangerous change to the Medicare Part D Payment Modernization Model that would limit access to treatments within the “six protected classes” of medications. If implemented, this model will negatively impact millions of patients by allowing health plans to opt out of including all drugs in the “six protected classes” on their Part D formularies, instead allowing them to treat five of the six protected classes as they would others within Part D in the first year of implementation and all six the subsequent year. In addition, the proposal would allow any plan participating in this model to include only one drug on the formulary for each class, down from the currently mandated two per class.
Currently, there are millions of seniors and patients with chronic diseases and disabilities who rely on access to the full range of medicines within the six protected classes to ensure their health and wellbeing, particularly those living with depression, epilepsy, cancer, autoimmune disorders, and HIV/AIDS, as well as those receiving organ transplants.
This drastic change removes vital protections for vulnerable patients without lowering out-of-pocket costs. Critical medications may no longer be covered by a patient’s plan, forcing them to switch to other treatments that may not fully address their medical needs, or they may be forced to pay the full cost of the medicine out-of-pocket. A one-sized-fits-all approach is not the right solution for Part D patients, especially the most vulnerable.
We cannot limit the therapeutic solutions available to doctors and patients, nor should we remove the best treatment options for specific chronic conditions. Putting money back into the pockets of beneficiaries and adding new layers of transparency to the rebate system, would help patients who rely on Medicare Part D for their health and well-being.
The California Chronic Care Coalition and many other leading health organizations are eager to see patient costs decrease without affecting their access to lifesaving medicines. Thank you for your time and attention to this issue, and I’m more than happy to schedule a time with you and your staff to discuss it further. Feel free to contact me at: email@example.com or (916) 444-1985.
Liz Helms, President & CEO
California Chronic Care Coalition
International Foundation for Autoimmune & Autoinflammatory Arthritis (AiArthritis)
Albie Aware Breast Cancer Foundation
Applied Pharmacy Solutions
Autism Society, San Diego
California Access Coalition
California Health Collaborative
California Black Health Network
California Hispanic Chamber of Commerce
Casting for Recovery
Community Health Action Network
Embracing Latina Leadership Alliances (ELLAS)
Epilepsy Foundation, San Diego County
Emphysema Foundation of America
Grateful Patient Project
Los Angeles Wellness Station
Latino Diabetes Association
Liver Coalition of San Diego
Looms for Lupus
Lupus Foundation of America
Lupus Foundation of Southern California
Mexican American Opportunity Foundation
Medical Oncology Association of Southern California (MOASC)
Neuropathy Action Foundation
NAMI, San Diego
Sacramento Black Chamber of Commerce
San Francisco Women’s Cancer Network
The Wall las Memorias