Summer is now in full swing, and while things generally slow down a bit to take time for vacation and relaxation, we find ourselves at AdverseEvents in the middle of something very exciting. We’re undertaking a huge effort to help shape policy for the benefit of health insurers, providers and most importantly, patients.

In late May, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule aimed to “modernize the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems”. In a quick summary, it aims to align with existing commercial, Marketplace, and Medicare Advantage regulations in order to improve the quality of care.

View the full 650 pages of proposed reforms here (digital format)

For the past 3 weeks, we’ve been keeping you up-to-date with our own policy efforts towards improving the quality and performance of Medicaid managed care organizations (MCOs). Missed it? Check them out here:            

 

So why are we telling you all this? We all need your help.

We submitted a letter providing comments on the proposed rule, including recommended changes to strengthen the Medicaid drug benefit within managed care programs.

 

Our recommendations to the CMS:

  • To incorporate reduction of preventable events affecting outcomes and costs, including adverse drug events, as part of CMS’ overall quality strategy
  • To incorporate reduction of post-approval adverse drug events as a performance measure
  • To require consideration of post-approval adverse drug event data in drug coverage decisions

You can view our entire comment letter here

 

How can you help?

If you agree that the analysis of post-approval adverse drug event data can improve patient outcomes and lower healthcare costs and will help Medicaid managed care programs increase transparency and make better prescription drug decisions, we encourage you to ask CMS to use existing, federal data on adverse drug events to evaluate the real world safety and cost of Medicaid covered drugs and biologics

 

  1. Write to your elected officials in Congress (download a template email letter), urging them to ask CMS to make evaluation of adverse drug event data a requirement for drug coverage decisions made by Medicaid and Medicare prescription drug plans. Search and find contact information for your Senators/Representatives.

    2. Submit your own comment on the proposed rule

 

CMS will be accepting public comment on this proposed rule until JULY 27th 2015

 

 

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Brian Overstreet

Brian Overstreet

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Brian Overstreet

Written by Brian Overstreet