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ACR Federal Advocacy Hot Issues

Legislation Introduced to Improve Patient Access to Treatments

On February 4, 2013, legislation was introduced in the U.S. House of Representatives to address barriers to treatment being experienced by patients with chronic conditions such as rheumatoid arthritis, lupus and psoriasis. Representatives David McKinley (R-WV) and Lois Capps (D-CA) introduced the Patients' Access to Treatments Act (H.R. 460). The Act would limit commercial insurance plans' cost-sharing requirements for medications in a specialty drug tier (typically Tier IV) to the dollar amount applicable to drugs in the non-preferred brand drug tier (Tier III).

Cost sharing is increasingly a problem for patients with chronic conditions as some commercial health insurance policies are moving vital medications, mostly biologics, into "specialty tiers" that utilize high patient cost-sharing methods. This "fourth tier (IV)" commonly requires patients to pay a percentage of the actual cost of the drug – from 25% to 33% or more – placing medically necessary treatments out of reach of insured Americans.

Take Action Today!
Contact your representatives using the ACR Legislative Action Center and ask them to sign on to the Patients' Access to Treatments Act (H.R. 460).

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