The Rheumatoid Arthritis Support Group of Central Oregon (RASGCO) helps patients with rheumatoid arthritis (RA) navigate their disease and live their best lives. We are strong supporters of ensuring that all RA patients are able to get the best treatment available. As such, we are opposed to insurance industry efforts to ration care through a process called step therapy.
RA is a debilitating condition in which the immune system attacks the joints, especially the hands. It can be difficult for an RA patient do simple tasks like preparing a meal, writing with a pen and paper or getting dressed.
Many of RA patients receive health care coverage through a Medicare Advantage plan where RA medicine is covered by Medicare Part B. The Centers for Medicare and Medicaid Services (CMS), however, recently announced a new policy that will now allow Medicare Advantage plans to require step therapy for treatments covered by Medicare Part B.
Under this policy, Medicare Advantage plans can force doctors to prescribe pre-selected treatments even if they are potentially less effective. Only when those initial treatments fail can patients move on to the treatment recommended by their physician.
It seems unfair that RA patients will have to take medication that my physician knows is less effective just to save an insurance company some money. RA patients will be exposed to needless pain and restrictions.
CMS should not be enabling insurance profiteering at the expense of patients. This policy goes into effect in 2019. Our federal leaders must act.
— Alyce Jantzen, Redmond
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