Power. Progress. Prevention. August 17, 2018

Published on August 17, 2018

Updated on September 28, 2018

Power. Progress. Prevention. -- An Advocacy Newsletter

August 17, 2018

Short-term plan rule finalized

The Trump administration recently released its final rule on short-term, limited duration health plans, set to take effect in two months. The rule will expand the maximum duration of these plans from three months to one year, with the potential to renew for up to three years. These plans could leave people with inadequate health care coverage and raise premiums in the Affordable Care Act (ACA) marketplace.

Short-term plans were meant to “fill the gap” for those transitioning between health care plans; they do not offer comprehensive benefits and are not subject to ACA requirements, such as essential health benefits–which include screening and early detection services. Without regular screenings and preventive services, people may not detect cancer until later stages, when treatment is less likely to be successful. Those who receive a cancer diagnosis while on short-term plans will also be left without adequate coverage of treatment and care.

The Prevent Cancer Foundation® supports increasing access to health care, but limiting the scope of coverage could have serious consequences. If you have questions about insurance in your state, contact your insurance commissioner’s office.

New study reveals cancer prevention is the most compelling reason for HPV vaccination

According to a new study published by the National Center for Biotechnology, cancer prevention was the most compelling reason for parents to consider in vaccinating their children against the human papillomavirus (HPV).

Health care professionals can significantly influence a patient’s decision to receive the HPV vaccination, or in the case of young patients, the parents’ decision. Only 39.7 percent of adolescent girls and 21.6 percent of adolescent boys in the U.S. have completed the vaccination series, and more than 60 percent of parents say their children’s pediatricians have not stressed the importance of getting the HPV vaccine. The Prevent Cancer Foundation® is calling on health care professionals to take the pledge to talk to their patients (and their parents) about the HPV vaccine.

Parents, you can learn more about the HPV vaccine and keep track of your kids’ vaccinations with A Guide to Vaccination for Parents (brought to you by the Prevent Cancer Foundation® and Scholastic®).

For more information on the link between HPV and cancer, visit our HPV and Cancer page.

New bill puts Prevention and Public Health Fund at risk

Senators Orrin Hatch (R-UT) and Marco Rubio (R-FL) have introduced the Puerto Rico Economic Empowerment Act to provide additional support for recovery efforts in Puerto Rico in the aftermath of Hurricane Maria. If passed, the bill would redirect resources from the Prevention and Public Health Fund (PPHF), draining funds intended for prevention and early detection services and scientific research.

Providing aid for Puerto Rico is critical, but it should not come at the expense of public health. Take action, share your story and tell your senators to protect prevention!

CMS to allow Medicare Advantage plans to use step therapy

The Centers for Medicare and Medicaid Services (CMS) last week announced Medicare Advantage plans will be able to implement step therapy for physician-administered drugs. With step therapy–also called “fail first” –insurers can require physicians to prescribe lower cost or older treatments before moving on to other options. Step therapy can interfere with a health care professionals’ ability to prescribe appropriate and effective treatments for their patients.

CMS has released some guidelines on how step therapy will be applied:

  • It may only be utilized on new treatments for patients. Patients can remain on their current drug treatments without any changes.
  • There must be an expedited exceptions process to allow health care professionals to prescribe drugs that fall outside the parameters set by the insurer.
  • Drugs may be “mixed and matched” between physician-administered and self-administered drugs, meaning that patients can be required to use a retail drug from a pharmacy OR the hospital–depending on which is cheaper.
  • Medicare is required to notify patients whose plans include step therapy to give them the opportunity to switch plans.

CMS Administrator Seema Verma says plans will be required to share half the cost-savings with patients. This cost-savings may result in lower premiums, but no formal plan for how savings will be shared has been announced.

To learn more about CMS’ plan for step therapy, view their fact sheet.

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