Standards of Service
NHF is dedicated to ensuring that those affected by bleeding disorders have access to quality medical care and services regardless of financial circumstances, place of residence, or other factors. Access to the comprehensive care model provided by hemophilia treatment centers is a critical component of quality care, as is access to pharmacy providers that are knowledgeable and experienced in the area of hemophilia and related bleeding disorders.
In order to achieve optimal patient outcomes, it is important that these pharmacies meet a uniform set of standards. Variability between pharmacy providers, irrespective of type (340B, PBM, small or large specialty pharmacy), may result in problems with patient access to necessary medication and ancillary supplies.
NHF’s Medical and Scientific Advisory Council (MASAC), has developed minimum standards for pharmacy providers that deliver clotting factor for use in the home, MASAC 188. Currently compliance with these standards is self-reported by pharmacy providers to NHF.
NHF and our member chapters have made efforts to work with legislatures and policymakers across the country in an attempt to have MASAC recommendations recognized in law and/or policy as “the” standard of care/service for providers of clotting factor.
Why the Need for Laws/Policies
Payers, in both the private and public arenas, continue to try to control spiraling health care costs through various cost saving techniques, such as narrowed provider networks, prior authorization processes, lower reimbursement rates and in some cases preferred drug lists. Having standards that are mandated by state law and or policy will ensure that the providers included in plan networks are both knowledgeable and experienced in addressing the needs of those affected by bleeding disorders.
NHF contacted the National Association of Boards of Pharmacy (NABP) for assistance in educating state boards of pharmacy about Medical and Scientific Advisory Council (MASAC) recommendation 188 and the need for minimum standards for pharmacies that serve people with bleeding disorders. In response to our request, an article titled “States Look at Standards of Service for Pharmacies Serving Hemophilia Patients” was featured in the June-July 2013 issue of the NABP Newsletter.
To date, there are a few states that have been successful in securing standards of care/service laws in their state, such as New Jersey, California and Missouri. Others have been successful in securing standards of service into state Medicaid policies, such as Alabama and Illinois. In addition to these successes, NHF efforts have led to the inclusion of MASAC standards into various health plan policies. In the coming year, NHF will continue to work with health plans, state boards of pharmacy, Medicaid officials and state legislatures to establish national standards of service for providers of clotting factor.