On January 22nd, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule concerning eligibility, enrollment and cost-sharing for Medicaid and for plans offered on insurance marketplaces. The proposed rule gives states flexibility in developing plan benefits offered to Medicaid enrollees, provided that the benefits fall within the previously defined 10 categories of essential health benefits (EHBs). In addition, the CMS proposed guidelines increase the fees charged for certain services, including higher cost-sharing for certain drugs for all Medicaid beneficiaries.
NHF submitted a comment letter on February 21 emphasizing the need for adequate Medicaid benefits for people with bleeding disorders. In particular, we advocated for the EHBs for Medicaid enrollees to include access to HTCs, multiple pharmacy providers and the full formulary, and that there not be expensive cost-sharing requirements on drugs. To view this letter, click here. In addition, NHF signed onto a letter with 78 other patient advocacy groups, the “I Am Essential” coalition, sent to Kathleen Sebelius, the Secretary of the US Department of Health & Human Services, commenting on the proposed rule. Click here to view the letter and press release.