06/16/2021
OSMA Advocacy Efforts on Insurance Coverage of Drugs Highlighted
Earlier this week, the Columbus Dispatch published a series of articles highlighting the challenges many patients and physicians have with insurance coverage of drugs.
The series featured several issues which OSMA is involved in advocacy on at the Statehouse, including:
- Co-pay accumulator – OSMA is supporting House Bill 135, essentially would ban use of co-pay accumulators, practices by health insurers that prevent drug discounts from counting toward insurance deductibles and out-of-pocket-maximums in Ohio. The detailed article on this topic includes quotes from testimony on HB 135 by Monica Hueckel, OSMA’s Senior Director of Government Relations.
- Non-Medical Switching – OSMA is advocating alongside the Ohio Association of Rheumatology in support of House Bill 153, which would prohibit non-medical switching, which occurs when patients are forced, for no medical reason and often in the middle of a coverage year on their insurance plan, to switch to a less expensive treatment. This practice by insurers and pharmacy benefit managers (PBMs) can lead to poor health outcomes and even adverse events that require hospitalizations, emergency room visits, or other additional care needs. The Dispatch’s story describes the anguish non-medical switching can cause and the need for action to ensure patients can access the treatment prescribed to them by their physician. It also features OSMA member Dr. Stephanie Ott. An additional article also delved into the issue of drug formulary exclusions.
The Dispatch also published two separate pieces that include a glossary of terms to help readers with key definitions to understand the complex intricacies of their prescription drug coverage.
NOTE: To get full access for all of the stories linked above, you will need a Columbus Dispatch subscription.