(Boston, MA)- Statement from Health Care For All's Executive Director Amy Rosenthal regarding the Health Care Reform legislation approved by the House of Representatives last night:
"Health Care For All (HCFA) is very appreciative of the inclusion of important provisions in the House Health Care bill that would promote access to more transparent and affordable care for consumers in the Commonwealth. We are particularly pleased that this bill protects the integrity of the MassHealth program and commend House Ways and Means Chairman Jeffrey Sánchez for his strong commitment and defense of this critical program that ensures access to quality and comprehensive care for the most vulnerable among us.
"We are pleased that the final House bill includes tools to increase consumer transparency and access to accurate and timely information about provider networks. This provision requires provider directories to be easily searchable, available to the public, and updated at least monthly. It also would establish a task force, chaired by the Division of Insurance, to make recommendations for regulations improving the accuracy of provider directories to ensure consistency across carriers. The bill additionally makes progress in addressing surprise out-of-network bills for patients and increases transparency of provider network status."
"HCFA is also encouraged by the inclusion of two provisions aimed at addressing drug pricing. We believe that authorizing "Academic Detailing" will improve prescription drug prescribing by using trained experts to educate doctors on evidence-based prescribing, countering the marketing efforts of the drug industry. HCFA has also been advocating for years for transparency around prescription drug prices as they are the fastest growing component of health care cost growth. Currently, there is no oversight over rising drug prices, with the state and consumers forced to pay whatever price is asked. A provision of the bill requires drug companies to justify prices for their most rapidly increasing products, and to testify before the state's Health Policy Commission on their pricing. However, we encourage the conference committee to strengthen the language on this section requiring much more extensive disclosures.
"The proposed legislation also overturns "pharmacy gag rules" that add costs for patients when they buy prescription drugs. Under complex "clawback" contracts between insurers, pharmacy benefit managers and pharmacies, pharmacists are often required to charge patients their full insurance co-pay for a drug, even if the regular price charged to uninsured people is significantly less. The contracts even forbid the pharmacist from informing the patient that the drug would be cheaper if the patient did not use insurance. This section requires the pharmacy to inform the patient, and charge the lower price if the patient requests.
"We are particularly pleased that the bill makes progress towards expanding MassHealth eligibility for seniors. Currently, an eligibility cliff drops many low-income seniors from MassHealth eligibility, leaving them with only limited Medicare coverage and expensive premiums and out-of-pocket costs for prescriptions, premiums costs and deductibles. By expanding MassHealth coverage to more low-income seniors, the state can leverage substantial new federal funding and ease their burden.
"We are also interested in innovative models of care proposed in the bill such as authorizing expanded use of telemedicine, including for oral health services. Telemedicine provides an opportunity to treat patients using two-way, real time technology which can be particularly helpful to rural patients and others unable to be served by in-person care. By including oral health in the provision, the section facilitates the eventual use of dental therapists working under "general supervision." This would allow these mid-level dental professionals to serve patients in schools, senior centers and other places where regular dental care is difficult to access.
HCFA is also a strong supporter of Prevention and Wellness Trust Fund (PWTF), which is reauthorized in the bill. PWTF is an effective program that funds community partnerships among clinical providers, local health agencies, and community programs to offer preventive care interventions. The pilot program is expiring, and the provision in the bill would extend it indefinitely and identify a source of funding for the program.
"Health Care For All looks forward to engaging with lawmakers in the upcoming negotiations to align the House and the Senate versions of this omnibus health care legislation to ensure that these important provisions are included in the final bill."
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Health Care For All (HCFA) is a Massachusetts nonprofit advocacy organization working to create a health care system that provides comprehensive, affordable, accessible, and culturally competent care to everyone, especially the most vulnerable among us. We achieve this as leaders in public policy, advocacy, education and service to consumers in Massachusetts. For more information about HCFA, visit our website at www.hcfama.org. You can also call our free HelpLine (800) 272-4232 if you need help applying for health insurance.