Making ‘patient protection’ essential in Obamacare
Brian Hujdich | 8/2/2013, 5:58 a.m.
And just as with Medicare Part D, people getting their coverage through the new Exchanges or through expanded Medicaid should also be allowed access to necessary medicines and treatments while they are petitioning for coverage.
If HHS fails to establish a sufficiently robust appeals process, the Centers for Medicare and Medicaid Services needs to issue its own regulatory guidance bulking up the appeals mechanism. Doing so will ensure that patients will have some legal recourse if they're denied access to vital medicines.
HealthHIV is not alone in expressing serious reservations about the EHB rules. The Arthritis Foundation, National Alliance of Mental Illness, Parkinson's Action Network, and more than a hundred other patient advocacy groups have raised these and other concerns.
HHS needs to comprehensively and quickly address the problems with its EHB rules. Meanwhile, department officials must ensure that the appeals process is robust and patient-friendly. If HHS fails to act, Congress needs to take action to explicitly guarantee patient access to important medications.
Inaction will limit access to the medicines that people living with HIV and other chronic conditions need to survive and thrive, keeping the promise of Obamacare from becoming a reality.
Brian Hujdich is the executive director of HealthHIV in Washington, D.C., one of the nation's largest HIV nonprofit organizations.