Aimed Alliance Joins Five Organizations in Opposing Colorado Medicaid Reimbursement Policy

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Aimed Alliance has joined five organizations in voicing our opposition to a recently enacted Colorado Department of Healthcare Policy and Financing policy decision that will prohibit reimbursing health care providers for medication that remains in a single-use vial after it is administered to a patient. This policy impacts patients with complex conditions such as rheumatoid arthritis, psoriasis, and multiple sclerosis. Historically, Colorado providers have been reimbursed for discarded medication that remains in a single-use vial, but this policy change reduces the amount of money that providers receive when they administer these medications, which will interfere with their ability to deliver high-quality care. Aimed Alliance shares stakeholders’ concerns about the impact this could have on access to care for Medicaid beneficiaries.

Refusing to reimburse providers for unused medications could harm patients in several ways. This change in policy could incentivize health care providers to use single-dose vials multiple times (a practice commonly referred to as drug vial optimization, or DVO), or it could incentivize providers to refer patients to a different site of care, which could result in disruptions in care, increased costs, and poor disease management. Some providers may even refuse to treat Medicaid patients altogether due to the unfavorable reimbursement policy, reducing the number of providers available to deliver care to the Medicaid population.

Aimed Alliance opposes this policy because it reduces the financial viability of treating patients from single-use vials in the office setting. Consequently, this policy could result in significant increases in per-patient treatment costs due to an increased need for hospital-based care and avoidable treatment delays.

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