July 16, 2018

Health Care For All, along with MassPIRG, Health Law Advocates, Community Catalyst and the Massachusetts Senior Action Council recently wrote a letter on the issue of drug transparency to the conferees meeting to work out a final health care bill. We urged the Conference Committee to include strong transparency measures to help tackle the problem of skyrocketing prescription drug prices.

Prescription drug costs are currently the fastest growing healthcare expense – by far. For both public and private plans, increases in pharmacy costs far outpace every other expense. Rising drug prices are increasing health care costs, placing significant burden on consumers and putting pressure on the state budget.

A major obstacle in controlling drug price growth is a lack of transparency on pricing trends, rebates, discounts, and pharmaceutical benefit managers. Actual prices paid for drugs are hidden behind a complex veil of intermediaries, and effective transparency provisions would allow the public and policymakers to understand the causes of high prices and cost growth.

We urge the Conference Committee to adopt the Senate language, which provide for more extensive disclosures and would strengthen the ability of policymakers and the public to judge if we are getting good value for our billions spent on prescription drugs. We believe that Massachusetts should join a number of other states that have enacted strong transparency requirements to further the goals of affordable care.

If you are interested in understanding the extent of these factors, read the complete letter here.

-Louis Pratt

July 10, 2018

With both the House and Senate having passed ambitious health care bills this session, now a joint House-Senate conference committee is hammering out the differences to reconcile the two bills for final passage. Health Care For All recently provided comments to the legislature on our recommendations for provisions  to reduce health care costs, protect consumers, and strengthen our state’s health care system.

While Massachusetts has the highest insurance coverage rate in the country, there is still progress to be made to improve the quality and affordability of health care in the Commonwealth. Some of the reforms that HCFA believes are important which were included in both the House and Senate bills are:

  • establishing an academic detailing program to provide independent evidence-based education that focuses on the therapeutic and cost-effective utilization of prescription drugs;
  • requiring the Center for Health Information and Analysis (CHIA) to develop and adopt a uniform methodology to communicate information on how health care providers are assigned to tiers;
  • requiring pharmacies to charge consumers the off-the-shelf price (the price people would pay with no insurance) if it is lower than their copay;
  • requiring insurers to continue coverage past age 26 for dependents with substantial disabilities.

For our full letter to the Conference Committee with detailed explanations of our positions, please click here. Here are summaries of HCFA’s recommendations regarding the legislation:

June 6, 2018

The Massachusetts Senate recently approved their version of the Fiscal Year 2019 (FY19) state budget. The Senate version and the House version must now be reconciled through negotiation between the two chambers. Health Care For All (HCFA) has a number of budget priorities related to health care that have made it this far and should continue on to the final budget.

To find HCFA’s full FY19 Conference Committee letter with detailed explanations of our positions, please click here. You can find summaries of each budget priority that HCFA supports below:

  1. Restore Coverage for Periodontal Care For Adults on MassHealth

We urge the Conference Committee to direct MassHealth to reinstate coverage for periodontic services for adult MassHealth enrollees so that they are able to get the appropriate care that they need to maintain good oral, and overall, health.

  1. Establish a strong Office of Health Equity within EOHHS, and provide funds for the Office’s operation

We urge the Conference Committee to include Section 7 and line item 4000-0009 of the House budget, which would establish and fund an Office of Health Equity to reduce the serious racial and ethnic health disparities that exist in Massachusetts.

  1. Provide expanded authority to MassHealth to negotiate for fair prescription drug prices

We urge the Conference Committee to include authority for MassHealth to seek supplemental prescription drug rebates, and require pharmaceutical pricing information from manufacturers if reasonable rebates are not provided to MassHealth. The provision should also allow EOHHS to assess penalties on manufacturers who refuse to provide the required information, or who do not offer fair rebate amounts to MassHealth.

  1. Direct MassHealth to provide information on ACO outcomes and activities addressing social determinants of health

We urge the Conference Committee to include language in the MassHealth line item (4000-0500) directing MassHealth to provide information on ACO outcomes and performance, particularly data on ACO activities addressing the social determinants of health.

  1. Fund critical children’s mental health programs

We urge the Conference Committee to fund the MHAP for Kids program at $50,000 (within line item 4800-0200).

We urge the Conference Committee provide level-funding for Return to School “Bridge” Programs at $250,000 (within the School Health Services line item 4590-0250).

  1. Preserve Sunset on Prescription Drug Marketing Coupons on Rebates

We urge the Conference Committee to maintain the state’s prohibition on drug industry marketing “coupons” by 2019 and direct the Health Policy Commission to engage in a substantive study of the long-term costs and benefits of drug coupons on the Massachusetts health care market.

  1. Provide Unbiased Information about the Cost and Efficacy of Prescription Drugs

We urge the Conference Committee to provide funding for Health Policy Commission to operate the Academic Detailing program (line item 1450-1266 of the Senate budget) at $150,000.

  1. Require data collection on pediatric continuous skilled nursing services

We urge the Conference Committee to include Section 16 of the Senate budget, which directs the Center for Health Information and Analysis and MassHealth to regularly report data about pediatric patients requiring Continuous Skilled Nursing services.

  1. Fund pediatric palliative care programs

We urge the Conference Committee to fund Pediatric Palliative Care Programs (4590-1503) at $3,816,053, to ensure that all children and families who need these services can get them.

  1. Adequately fund DPH’s Office of Oral Health and the successful ForsythKids Program

We urge the Conference Committee adequately fund the general operations of DPH’s Office of Oral Health, and continue to earmark $300,000 for the ForsythKids program (line item 4512-0500).

Each of these provisions serve important purposes in supporting health care in Massachusetts. As always, HCFA is committed to advocating for affordable and quality health care coverage. All ten of these proposals do just that.

-Brian Rosman and Davis Jackson

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