Sondra Rothwell and Dawn Warner attended the legislative fly-in in March with the Autoimmune Association.
Click to join forces with he Autoimmune Association to support the HELP COPAY ACT.
Join our team of volunteers and make a difference in your community. Whether you can give a few hours a week or a few hours a month, your time and skills are appreciated. We are currently seeking patient advocates.
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Systemic Issues (hours, wait time for appointment)
This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy (or fail first) protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer.
A request for such an exception to the protocol must be granted if:
(1) An otherwise required treatment has been ineffective.
(2) The treatment is expected to be ineffective and delaying effective treatment would lead to irreversible consequences.
(3) The treatment will cause or is likely to cause an adverse reaction to the individual.
(4) The treatment is expected to prevent you from performing daily activities (ADL) or occupational responsibilities.
(5) You are stable on your current prescription drugs already selected by your provider and the drug has been covered by your previous or current insurance plan.
(6) There are other circumstances as determined by the Employee Benefits Security Administration.
** Source: Congress.gov
The Act will help reduce patient out-of-pocket expenses by requiring insurance plans to include the copay assistance coupons and other copay assistance programs towards your deductible. This means access to more care and lower cost sharing obligations. Contact your state and house representative and ask for their support!
Our Congressional ask was to FULLY fund the Office of Autoimmune Disease Research through the National Institutes of Health. This allows all of the autoimmune diseases to benefit from the research. Autoimmune diseases are costly to treat. A coordinated effort is required to do the research and make the discoveries that will impact autoimmune diseases as a class. This is already being done for cancer and infections, each of which has a dedicated institute.