Senator Grassley and Senator Brown Urge CMS to Maintain Policy Requiring Medicare Part D Plans to Carry Medicines in Six Categories

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Update: On June 30, 2016 Senator Chuck Grassley of Iowa and Senator Sherrod Brown of Ohio wrote to the federal Centers for Medicare and Medicaid Services (CMS) and have recommended and urged Acting Commissioner Andy Slavic to have the agency maintain current policy requiring that Medicare prescription drug plans carry six categories of prescription drugs offered to participating beneficiaries.

The six protected classes are anticonvulsants, antidepressants; antineoplastics, antipsychotics, antiretrovirals, and immunosuppressants for the treatment of transplant rejection. Senator Grassley’s office has confirmed that the letter was sent on July 5, 2016.

The Grassley-Brown letter is available here.

In June 2016, the Medicare Payment Advisory Commission (MedPAC) released a report where they recommended changes be made to this important and popular policy. Even while making this recommendation the Medicare Payment Advisory Commission’s report stated that “the degree to which plans could achieve additional savings is unclear.”

Senator Chuck Grassley and Senator Sherrod Brown stated that regardless of potential savings, they have serious concerns wth the Medicare Payment Advisory Commission’s recent proposal and recommendation and urge the federal Centers for Medicare and Medicaid Services (CMS) “to maintain the six protected classes policy as it currently exists.”

Under the current policy, a Part D plan is required to cover all or substantially all drugs in six therapeutic classes: antiretrovirals, immunosuppressants when used to prevent organ rejection, antidepressants, antipsychotics, anticonvulsant agents and antineoplastics.

MedPAC suggested removing  immunosuppressants used to prevent transplant rejection and to remove antidepressants  from the list. The commission stated that their recommendation would allow patients to switch to generic medications and this would save money.  They admitted that they had no idea how many people wold be impacted by this change and they had no idea exactly how much money could be saved.

Readers of this website will note that there have already been two occasions where the federal Centers for Medicare and Medicaid Services (CMS) tried to make this change by their internal “rule-making”. The first time was in 2012 and they tried again in 2014.

LI TRIO and other dedicated advocates and stakeholders helped state the important case to precent these changes and members of both parties in Congress vehemently opposed the idea to no longer protect  immunosuppressants when used to prevent organ rejection, antidepressants, antipsychotics, anticonvulsant agents and antineoplastics.

In other words, The federal Centers for Medicare and Medicaid Services (CMS) have already tried to limit the categories by regulation, then dropped its plans after public outcry and letters from Members of Congress. Now it’s time to spread the word and help keep the protected classes of medications protected.-Mike Sosna

Senator Chuck Grassley

The Grassley-Brown letter is available here.

Grassley and Brown and brown sent this letter urging Acting Commissioner Andy Slavitt and the agency to maintain Medicare’s current six protected classes policy

June content:
Senator Chuck Grassley and Senator Sherrod Brown are the sponsors of legislation requiring the maintenance of the “six protected classes.” “Despite Part D’s success and the effectiveness of the six protected classes policy, the Medicare Payment Advisory Commission (MedPAC) report released in June 2016 included a recommendation to make changes to this popular policy,”

Under current policy, Medicare Part D plans must include all covered drugs in six protected categories and classes in their plan formularies: anticonvulsants, antidepressants; antineoplastics, antipsychotics, antiretrovirals, and immunosuppressants for the treatment of transplant rejection. The policy is meant to “safeguard access to lifesaving medicines for vulnerable Medicare beneficiaries who rely on these classes of prescription drugs to protect them from potential challenges associated with any interruption of therapy,” Grassley and Brown wrote.–

“In its recommendation, however, MedPAC acknowledges that ‘the degree to which plans could achieve potential savings is unclear.’ Regardless of potential savings, we maintain serious concerns with MedPAC’s recent proposal and urge CMS to maintain the six protected classes policy as it currently exists.”-Senator Grassley and Senator Brown