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November Advocacy Updates

Nov 14, 2018

Update on the Expanding Access to DSMT Act

Following an exciting midterm election season, Congress will return to Washington for a “lame duck” session to wrap-up any remaining legislative business in the final days of the 115th Congress.  Given the limited left in the Congress, AADE’s Advocacy Department wanted to share an update on this session’s progress relative to our federal legislation, the Expanding Access to DSMT Act (H.R.5768; S.3366). AADE representatives, along with members of the Diabetes Advocacy Alliance (DAA), have been actively meeting with congressional offices to discuss the benefits of DSMT and how this bill would help seniors with diabetes have better access to care.  AADE members have also been writing to, meeting with, and contacting their members of Congress to help garner support for this legislation. At the time this article was written H.R. 5768 had six co-sponsors and S. 3366 had two co-sponsors.

As the bills are still in committee, they are unlikely to pass in the “lame duck” session, yet we have been working to lay the groundwork for their introduction and passage in the 116th Congress. If you haven’t already done so, please visit AADE’s Legislative Action Center and send a letter to your congressional representatives urging them to support the bill. We appreciate the support of AADE members in building the momentum to advance this legislation.

AADE Member and Diabetes Educator Jasmine Gonzalvo Appointed to the National Clinical Care Commission

Jasmine Gonzalvo, PharmD, BCPS, BC-ADM, CDE, LDE, FAADE has been appointed by U.S. Health and Human Services Secretary Alex Azar to represent diabetes educators as a member of the National Clinical Care Commission (the Commission). The Commission is charged with improving coordination across federal programs to reduce inefficiencies, address gaps, and enhance clinical care. As a member of the Commission, Jasmine will be able to directly inform and impact federal policies related to diabetes, and other metabolic and autoimmune diseases. Jasmine is one of only 12 non-federal members appointed to the Commission- a significant distinction. The Commission held its first meeting on October 31. At this meeting, Jasmine was officially sworn-in as a Commission member and AADE was able to provide oral testimony, sharing key aspects of AADE’s vision for the specialty of the diabetes educator that align with the Commission’s charter and described duties. Click here to learn more about Jasmine’s role as a member of the Commission.

AADE weighs in on proposed coverage policy for CGM in Michigan

Effective December 1, 2018, the Michigan Department of Health and Human Services (MDHHS) will begin Medicaid coverage of personal use continuous glucose monitors (CGM). The MDHHS released a proposed policy draft in early September that outlined the standards of coverage, documentation, prior authorization, and payment rules for this coverage policy. AADE was able to work with the Michigan CB to review the draft coverage policy and weigh-in on certain provisions, like expanding this benefit to include people with type 2 diabetes in addition to those with type 1 diabetes. Review AADE’s letter to the MDHHS.

Federal Bills Prohibiting “Gag Clauses” Signed into Law

In October, President Trump signed into law two bipartisan bills that ban so-called “gag-clauses” which prohibit pharmacists from informing customers that their medicine may be cheaper if they pay cash for certain drugs rather than using their health insurance. The Patient Right to Know Drug Prices Act affects commercial insurance contracts and will immediately prohibit insurers and pharmacy benefit managers (PBMs) from restricting a pharmacy’s ability to provide drug price information to an enrollee when there is a difference between the cost of the drug under the plan and the cost of the drug when purchased without insurance. The Know the Lowest Price Act would extend the same protections to individuals who are covered by Medicare Advantage and Medicare Part D plans, though this law will not take effect until January 1, 2020. These laws are intended to provide more options for people with diabetes and other chronic conditions to save on drug costs and co-pays.

Join AADE for an Advocacy Webinar on December 4

Representatives from AADE’s Washington, DC-based consulting firm, Baker Donelson, will be the featured speakers for a webinar on December 4 from 1:00-2:00pm Eastern entitled “Washington Policy Recap and Look Ahead to the 116th Congress.” This webinar will provide a policy overview of what’s currently happening in Washington and what to expect as the new congressional session takes shape. The webinar will focus on the status of the Expanding Access to DSMT Act (H.R. 5768, S. 3366) and how we are already laying the groundwork for the upcoming congressional session. The webinar will address any “need to know” regulatory changes for 2019, including preliminary updates from the Medicare Physician Fee Schedule final rule. Click here to register.

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