• hoi_director@hemophiliaofiowa.org
  • 319.393.4007

Federal Legislation

Federal Legislation

What's happening at the federal level?

There is much at risk for change, elimination of lifetime or annual limits on essential health benefits, elimination of rescission in all health plans except in the case of fraud, guaranteed issue and renewal – everyone is guaranteed access to an insurance plan regardless of health status or utilization of health services,elimination of pre-existing conditions for all and extension of coverage for adult children up to age 26.

In 2010, the Affordable Care Act (ACA) established a new regulatory pathway for a class of drugs known as biosimilars. The new abbreviated regulatory pathway established by the ACA may enable patients to have access to more affordable biosimilar products in addition to the biologics that they are already using. Easier access to biosimilars also comes with risks to patient safety that requires evaluation.

The Patients’ Access to Treatment Act (HR 1600) states that an insurance company cannot charge more for a drug that they place on a specialty tier than they charge for drugs placed on their non-preferred brand tier.

 High quality insurance with adequate networks and formularies is necessary to preserve access to hemophilia treatment centers and specialized hematologists, a wide variety of clotting factor, and the services necessary to properly manage a bleeding disorder. Without affordable access to treatment and care, managing a bleeding disorder becomes nearly impossible. The types of plans necessary to adequately cover the cost of a chronic condition often come with a high premium.

Step therapy is a coverage restriction placed on drug coverage by private health plans and Medicare private drug plans. Before your plan will cover some (generally more expensive) drugs, you must try other (generally less expensive) drugs that treat your condition to see if they will be effective for you.

Before 1965, hemophilia was treated with a slow transfusion of whole blood or fresh frozen plasma. In 1965, a plasma extract called cryoprecipitate became available that made Hemophilia A treatment much easier and more effective. By the early 1970s, clotting factor for Hemophilia A and B became available in a concentrated, freeze-dried form. However, because the clotting factor was made from the blood of many donors, the majority of those with hemophilia were infected with hepatitis B and C viruses (HBV and HCV) and with the human immunodeficiency virus (HIV), the virus that causes AIDS.

@ 2017 Esol Theme powered by WordPress Developed by ASIATHEMES