A concerted effort by the National Hemophilia Foundation (NHF), in conjunction with other community organizations, homecare companies and manufacturers of anti-hemophilic factor products, has successfully dissuaded the Alabama Medicaid Agency from severely reducing its reimbursement formula for factor. In December, the agency sent a letter to all factor providers in the state announcing that effective February 26, 2007, it would reimburse for factor based on Public Health Service rates. This change could have prevented most of the current factor product providers in the state from serving Medicaid recipients. This, in turn, might have significantly limited the options these individuals would have had to access products and services.
All of the national organizations, including NHF, the Hemophilia Federation of America, and the Committee of Ten Thousand (COTT), sent letters to the agency explaining why its proposed formula was inappropriate and potentially harmful. NHF also reached out to the regional office of the Center for Medicare and Medicaid Services (CMS), which contacted Alabama Medicaid and expressed its shared interest and concern. In addition, representatives of factor providers met with Alabama Medicaid representatives to share their own perspective.
A letter arrived in early January from the agency to all of the interested parties reporting that the new reimbursement formula would not be implemented. This represents another important victory for NHF and the community at large in the fight to preserve broad access to high quality care. At the same time, it also demonstrates the continuing trend towards curtailing Medicaid at the state level. These efforts, which are often based on the provisions of the Deficit Reduction Act, have included not only proposed changes to reimbursement formulas but also the introduction of preferred drug lists and other forms of prior authorization. In addition, the trend is not limited to Medicaid and other governmental agencies, but extends to all public and private bodies that reimburse for factor and other kinds of medical care. NHF will continue to closely monitor these activities and will work with our community partners to oppose all threats to access to care. We will keep you apprised of the latest developments.