Senate Finance Committee Unanimously Passes P4HA Supported Amendment to CHRONIC Care Act

WASHINGTON, DC, 5/18/17 - Prescriptions for a Healthy America (P4HA), the medication adherence campaign of the Council for Affordable Health Coverage, praised the Senate Finance Committee's passage of S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017. 

The committee-passed bill includes an amendment offered by Senators Tom Carper (D-DE) and Pat Roberts (R-KS) and championed by P4HA providing Medicare Parts A and B claims data to Part D Plans in order to enhance the effectiveness of current and future medication management programs. The P4HA-supported amendment was passed by a voice vote and was the only amendment passed out of committee. 

P4HA Executive Director Sloane Salzburg released the following statement: 

"Medication non-adherence is a $300 billion problem that claims the lives of at least 125,000 Americans each year. The Carper-Roberts amendment to the CHRONIC Care Act, vigorously supported by P4HA and its partners, offers a bipartisan, commonsense step towards addressing this challenge by ensuring better information about hospital and physician encounters is shared with Medicare drug plans. These encounters may change which medicines a patient can or should be taking, but today, plans have little to no information on an enrollee’s visits to hospitals or ambulatory providers," said P4HA Executive Director Sloane Salzburg. "As it stands today, there can be a dangerous disconnect between the clinical setting, where patients are diagnosed, and the pharmacy setting, where patients receive their medications. This amendment would better coordinate pharmacy and medical care so that Part D plans can identify patients most at risk of medication mismanagement and adapt their treatment plan accordingly. We believe this measure will reduce costs and, most importantly, save lives. P4HA is grateful to Senators Carper, Roberts, and members of the Senate Finance Committee for their leadership on this critical legislation." 

P4HA Supports S.3454

— FOR IMMEDIATE RELEASE —

Prescriptions for a Healthy America Commends Medication Adherence Bill

WASHINGTON, D.C., (October 3, 2016) — Prescriptions for a Healthy America, the medication adherence campaign of the Council for Affordable Health Coverage, commends Senator Carper and Senator Roberts for introducing a bill to improve medication adherence (S. 3454).

Medication non-adherence, when patients don’t take their drugs as prescribed, costs an already strained health care system $290 billion a year. And unfortunately, non-adherence is widespread. More than half of all Americans are not taking their medications properly — which worsens America’s health affordability crisis with preventable hospital and emergency room visits.

This cannot continue. Senators Carper and Roberts’ bill would help identify those at risk of medication-related issues by sharing Medicare A and B claims data with Part D plans; and redefining “medication management” as “quality improving.” The redefinition would reduce the administrative costs associated with medication management activities, incentivizing plans to offer them. Furthermore, the bill allows MA-PD plans, where more than one-quarter of seniors receive their benefits, to test innovative new strategies to promote adherence.

Improving medication adherence across America should be a priority for Congress and we support Senators Carper and Roberts’ leadership on this issue. Passing this bill swiftly will reduce health costs and save lives.

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Prescriptions for a Healthy America
Prescriptions for a Healthy America: A Partnership for Advancing Medication Adherence (P4HA) was launched in 2013 by the Council for Affordable Health Coverage. P4HA brings together leading patient, physician and health care industry leaders to urge policymakers to implement near-term solutions that will help reduce health care costs and improve the lives of patients across the nation.

Report Offers Democratic Governors Options for Improving Medication Adherence

A report prepared for the Democratic Governors Association suggests policy options for getting Medicaid beneficiaries to take their medicine that include managing medication, coordinating prescription refills, allowing more time between refills and generally teaching people why they should do what their doctor tells them. The recommendations primary apply to Medicaid, but they could also apply to state employee health plans and exchange insurance, the report states.

The paper states that it’s key to use medication therapy management only on those patients who need it. CMS recently scrapped a proposal to expand MTM in Medicare in part because plans complained that they would lose money if forced to contact enrollees who don’t need the service. The medication-adherence coalition Prescriptions for a Healthy America is now working on a legislative proposal aimed at better targeting people who need MTM.

That coalition- which includes pharmaceutical, chain drug store and pharmaceutical benefit manager members- also contributed to the paper prepared for the Democratic governors. That paper says “super user” programs could offer MTM to the approximately 5 percent of beneficiaries who are in those programs. It points out that an evaluation of 14 super-user programs found that teaching medication adherence is a key feature in all of those programs so it’s a natural step to go further with MTM. There also are 20 states with MTM programs that other states could look to, according to the paper.

Source: Inside Health Policy, 6/6/14