Hemophilia Federation of America is a national nonprofit organization that assists, educates and advocates for the bleeding disorders community.
One key provision of the Affordable Care Act (ACA) requires most health insurance plans to cover 鈥 without cost-sharing 鈥 services that help screen for and prevent disease. Annual primary care visits, immunizations, cancer screenings, and improved access to birth control are just a few of the categories of preventive services that are available without […]
Lawmakers in June voiced renewed interest in scrutinizing the role that pharmacy benefits managers (PBMs) play in our health care system. PBMs are middlemen that create and administer drug formularies on behalf of health insurers, self-insured employers, Medicaid, and other payers. PBMs choose which drugs a plan will cover, purchase those drugs, set payment terms […]
Federal courts tackle questions surrounding copay accumulator adjusters While HFA and allies continue advocating for sound laws and regulations regarding copay assistance, we are also monitoring a couple of noteworthy (if weedy!) court cases relating to copay accumulator adjusters (CAAPs) and copay maximizers. On May 4, drug manufacturer Johnson & Johnson filed suit in federal […]
The so-called 鈥渇amily glitch鈥 is one of the persistent deficiencies in the Affordable Care Act. Under the ACA, people with access to employer-sponsored health coverage only qualify for subsidies to help them buy Marketplace health insurance if premiums for their employer plan are unaffordable (i.e., above 9.83% of household income). Affordability, however, is measured against […]
Government health agencies, while continuing to monitor COVID-19 trends, have begun planning for the end of the public health emergency. As previously reported, the U.S. Department of Health and Human Services has for two years kept in place an official determination that COVID-19 constitutes a national public health emergency. While the PHE declaration remains in […]
Court strikes down portions of surprise medical billing rule, but patient protections remain in effect. Last month HFA reported on new federal patient protections against 鈥渟urprise鈥 medical billing that went into effect on January 1, 2022. Under the new law and regulations, health care providers can no longer bill patients for amounts above their regular […]
Readers of the Washington Wire will have noticed that HFA publishes a lot of posts about 鈥渃opay accumulator adjuster programs鈥 (CAAPs). This is a weedy but important topic! CAAPs are a strategy used by insurers to redirect the value of manufacturer copay assistance 鈥 which is supposed to help patients afford their share of their […]
As we close out 2021, we want to reflect on HFA鈥檚 policy agenda: how our policy priorities shaped our advocacy efforts over the past year and what we expect and plan for 2022. HFA鈥檚 policy agenda always centers on access 鈥 access to treatments and care, access to quality health coverage, access to relief from […]
For the second year in a row, HFA鈥檚 Patient Fly-In took place as a virtual event. Two dozen community members together with HFA staff made forty (!) Zoom visits with Congressional offices during the week of November 15th. The timing of the Fly-In 鈥 always a bit of a gamble 鈥 ended up being very […]
Policy and advocacy sessions were among the many programs on tap at HFA鈥檚 recently concluded 2021 Symposium. Thank you to all who attended! It was wonderful to 鈥渟ee鈥 you at our virtual event 鈥 even as we plan, and fervently hope, to see you in person at HFA鈥檚 2022 Symposium in San Antonio. For those […]
As September ends, HFA continues to closely monitor action on the 鈥淏uild Back Better鈥 Act. Congressional leaders are trying to pass this legislation, which embodies President Biden鈥檚 social infrastructure agenda, via the budget reconciliation process (i.e., a simple majority vote, almost certainly along party lines). The bill, which includes numerous health care proposals, comes with […]
With Medicaid much in the news in August, it seemed timely to offer a refresher on how Medicaid is structured, and why it鈥檚 important to many in the bleeding disorders community. Medicaid is a public health insurance program for low-income individuals, families, seniors, and people with disabilities. States set up and run their own Medicaid […]
Administration Issues First Rule on the No Surprises Act On July 1, the Administration issued a first set of rules implementing the聽No Surprises Act. The statute and rules target the all-too-common problem of surprise or balance billing. Surprise billing can happen when a patient inadvertently gets services from an out-of-network (OON) health care provider. Maybe […]
The Affordable Care Act Remains the Law of the Land On June 17th, the U.S. Supreme Court handed down its long-awaited decision in California v. Texas, a case challenging the constitutionality of the Affordable Care Act. By a 7-2 vote, the Supreme Court held that the parties objecting to the ACA (18 state attorneys general […]
ACA ENHANCEMENTS BOOST HEALTH PLAN ENROLLMENT The U.S. Department of Health and Human Services announced on May 11 that more than 1 million Americans have signed up for coverage on www.HealthCare.gov during the Special Enrollment Period (SEP) that opened February 15. The SEP 鈥 still ongoing, in most states 鈥 creates broad new opportunities for […]
States Act to Protect Consumers from Copay Accumulators In a major victory for consumers, Kentucky, Oklahoma, and Arkansas enacted legislation this month to prevent health plans from pocketing the copay assistance that provides a critical lifeline to persons with bleeding disorders and other costly conditions. Health plans鈥 use of harmful 鈥渃opay accumulator adjusters鈥 鈥 the […]
COVID relief legislation makes health coverage more accessible and affordable On March 11, 2021, President Biden signed the $1.9 trillion American Rescue Plan Act into law. This sweeping measure provides economic relief to individuals, families, businesses, schools, and state and local governments. The law offers new incentives for holdout states to expand their Medicaid programs […]
Responding to the ongoing pandemic, the federal government has opened a special enrollment period (SEP) in the Healthcare.gov insurance marketplaces. This enrollment opportunity will run from Feb. 15聽to May 15聽in the 36 states that use the Healthcare.gov enrollment platform (most of the remaining states have already announced that they, too, will open a new 2021 […]
The 2021 federal health policy outlook started to come into sharper focus in early January, when runoff elections for both of Georgia鈥檚 Senate seats were decided. The election of Democratic Sens. Warnock and Ossoff means that the U.S. Senate is split 50-50 between the parties, with the Democrats holding the slimmest of majorities (Vice President […]
As we enter the new year, there are good reasons to hope the U.S. may soon round the corner on COVID-19. In the meantime, though, we all still need to follow the guidelines of our public health authorities: stay home if sick, practice social distancing, avoid indoor settings, wear masks, and wash our hands. Please […]
HFA鈥檚 virtual 2020 Patient Fly-in took place over the week of Nov. 16.聽 Sixteen community members connected with their lawmakers via phone and Zoom to describe what it鈥檚 like to live with a bleeding disorder 鈥 and to explain what people in this community need in terms of quality, affordable health coverage. Fly-in participants also […]
Open Enrollment begins for 2021 insurance plans Open Enrollment聽is a time frame each year when health insurance plans聽are required by law to accept applications from聽new plan聽enrollees regardless of their health history. This also is the time when you can choose to stay with your existing health plan if it is the right one for you. […]
Update on ACA lawsuit The death of eminent Supreme Court justice Ruth Bader Ginsburg on September 18th brought renewed attention to the fate of the Affordable Care Act. As previously reported, a lawsuit challenging the constitutionality of the ACA (California v. Texas) is pending in the Supreme Court. Because Justice Ginsburg was considered a likely […]
Policy and advocacy sessions sparked robust discussions at HFA鈥檚 recently concluded 2020 Symposium! Thank you to all who attended 鈥 it was wonderful to 鈥渟ee鈥 you at our virtual event. For those who couldn鈥檛 join us in real time, you can still view the recorded sessions on your own schedule for the next few months […]
Click Below to Translate Page to Spanish. Product recall announced On July 21, CSL Behring and Ferring Pharmaceuticals announced a聽recall聽of multiple lots of Stimate (desmopressin),聽in the United States and in other countries around the world. The recall was prompted by the manufacturer鈥檚 discovery of out-of-specification levels of the active ingredient in the marketed product. This聽announcement […]
U.S. Department of Health and Human Services releases rule paring back anti-discrimination provisions On June 12th, the HHS Office of Civil Rights released a final rule聽re-interpreting anti-discrimination provisions of the Affordable Care Act. The new rule removes explicit patient protections against discrimination by health care providers and insurers. HFA joined with twenty-eight other patient and […]
Click Below to Translate Page to Spanish. Federal rule allows health plans to discount manufacturer copay assistance. On May 7, 2020, the U.S. Department of Health and Human Services finalized a rule that affects individuals who rely on聽patient copay assistance programs. The HHS rule (the 鈥2021 Notice of Benefits and Payment Parameters,鈥 or NBPP) allows […]
Durante el mes de abril, la emergencia de COVID-19 continu贸 dominando las vidas de los estadounidenses y las agendas de los legisladores. Estas son algunas de las novedades del mes. Un cuarto proyecto de ley de alivio de COVID se convirti贸 en ley el 24 de abril. R. 266 repone el Programa de Protecci贸n de […]
Over the month of April, the COVID-19 emergency continued to dominate Americans鈥 lives 鈥 and lawmakers鈥 agendas. Here are some of the month鈥檚 developments. A fourth COVID relief bill was signed into law on April 24th. R. 266 replenishes the Paycheck Protection Program (established in the March CARES Act but quickly depleted) with an additional […]
COVID-19 cambi贸 la vida de pr谩cticamente todos en el transcurso del 煤ltimo mes, y parece probable que las interrupciones en el trabajo, la escuela, la atenci贸n m茅dica y la vida cotidiana en todo el pa铆s contin煤en por un tiempo m谩s. En medio de esta perturbaci贸n, HFA quiere asegurarle que continuaremos sirvi茅ndole y apoy谩ndole. Estamos trabajando […]
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