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Amendment to Section 1927 of the SSA Act regarding Medicaid Payments for Covered Outpatient Drugs.

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Presentation on theme: "Amendment to Section 1927 of the SSA Act regarding Medicaid Payments for Covered Outpatient Drugs."— Presentation transcript:

1 Amendment to Section 1927 of the SSA Act regarding Medicaid Payments for Covered Outpatient Drugs

2 Our purpose We enable people with life-altering conditions to lead better lives. A Federal Legislative Solution to Improving Medicaid Coverage of Rare Disease Therapies Jay Greissing Dir., U.S. Gov’t Relations and Public Policy September 19, 2014

3 To be as brave as the people we help. 3 Medicaid Coverage Restrictions Step Therapy Alaska Arkansas California Georgia Minnesota Denial Oregon – Section 1115 Waiver to establish Prioritized Health Services List

4 To be as brave as the people we help. 4 Solution Prohibit Medicaid plans from using restrictive step therapy protocols when: The drug is prescribed for a rare disease; and The rare disease is an FDA approved use

5 To be as brave as the people we help. 5 Why Should The Community Partner to Petition Congress? EEquity for individuals w/ rare conditions PPhysician and patient preference IInnovation of and access to individualized treatments CContinuity of care


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