Aimed Alliance has signed on to the “I Am Essential” coalition’s letter, urging the United States Department of Health and Human Services (HHS) to better define discriminatory plan practices in its final rule. The letter encourages HHS to explicitly prohibit certain cost containment practices, such as placing all or most medications that treat a certain condition on the highest cost tier, not covering certain medications, not following treatment guidelines, imposing unreasonable prior authorizations or fail first policies, charging patients high cost-sharing rates, and having narrow provider networks. The HHS’s proposed rule does an adequate job of defining discriminatory practices by insurance plans for some individuals, but it does not define discriminatory practices in plan benefit design as it relates to all beneficiaries, particularly those with serious and chronic health conditions who rely on prescription medications and other healthcare services.
In order to protect beneficiaries and to provide clarity to state and federal regulators, now and in the future, HHS must provide a clear definition of what constitutes discrimination. If your organization would like to sign onto the comment letter, you must fill out this form by 1 PM ET on November 6, 2015. You can read the letter in full here.
Last Updated on May 7, 2020 by Aimed Alliance
