ARxC Advocacy Actions June- September 2017

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1.    ARxC has been a strong supporter of repeal for the Independent Payment Advisory Board (IPAB) as part of the Affordable Care Act. IPAB is a fifteen-member United States Government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act which has the explicit task of  attaining specified savings in Medicare. The savings should come without affecting coverage or quality. However, we believe the IPAB’s recent mandatory cuts to Medicare, expected to be activated in 2017, will put senior’s healthcare access at risk through arbitrary cuts to Medicare services.  ARxC and 700 other organizations are urging Congress to act immediately so that the most important medical decisions remain in the hands of patients and their doctors. (See Letter to Rep. Hank Johnson on IPAB). *Please consider calling or writing your Congressperson to repeal the IPAB.


2.     Malnutrition Assessment for seniors has long been neglected. The Advocates for Responsible Care (ARxC) recently had the opportunity to comment on the Centers for Medicare and Medicaid Services’ (CMS) FY 2018 IPPS and LTCH proposed rule, “FY 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Proposed Rule, and Request for Information (CMS-1677-P),” and specifically to support the proposal to adopt malnutrition electronic clinical quality measures (eCQMs) and a potential malnutrition composite measure for future inclusion in the Hospital Inpatient Quality Reporting (IQR) and Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. ARxC is interested in the millions of older adults don't get enough of the nutrients they need to stay healthy. That weakens their bodies, heightens the impact of chronic disease and ratchets up our nation's healthcare costs. Those who have cared for an aging parent or had a chronic disease themselves may have witnessed firsthand how people can become malnourished. We proposed that CMS adapt malnutrition quality e-measures that will track how well institutions follow certain steps designed to improve nutritional care. (See ARxC's Letter to CMS on Malnutrition).


3.     Gun Violence has been increasing in Georgia and around our nation. ARxC is joining with community, civic and faith based organizations to address the need for sensible gun safety in Georgia. We hope to form a coalition that will propose common sense gun reforms.


4.   Blue Cross Blue Shield of Georgia, (BCBS) the only insurer on the exchange for 96 of the state’s 159 counties, is telling patients with individual policies that if they go to the emergency room and it’s not an emergency, they’ll be stuck with the bill. BCBS GA is seeking to limit ER coverage that would place patients in jeopardy to having access to critical care. The Medical Association of GA (MAG) and the Rx in Reach GA Coalition is opposing this irresponsible action of BCBS GA. There are many problems with their actions including patients being unreasonably responsible to determine an ‘emergency’, physicians unable to treat or be paid for services, rural areas are especially in need of more access to care not less, and many others. BCBS of Kentucky is also seeking to implement this practice. *We will soon be asking for a “Call to Action” to ask our legislators to stop this deliberate and cruel policy.


5.    ARxC continues to answer patient and provider calls for access to dialysis for uninsured patients. Unfortunately, uninsured and undocumented End Stage Kidney Disease patients cannot receive life-saving scheduled dialysis treatment in Georgia.


6.   ARxC continues to support the #I AM Medicaid campaign in Georgia. Medicaid is at risk. Right now, the U.S. Senate is negotiating a plan that would slash federal Medicaid funding and effectively end Medicaid expansion. Capping and cutting Medicaid would result in billions of dollars in health care costs shifted to all 50 states and place enormous pressure on state budgets. There is no way to cut Medicaid without harming people, including kids with special needs like autism, older adults who rely on nursing care and people with disabilities who need services to live independently.  *Please post to your Facebook and Twitter: #IamMedicaid to support funding for Medicaid for Medicaid expansion.


7.   The Congress is considering changes to Medicare Part D. The Medicare Part D drug plan is a federal government program designed by Medicare to help all citizens who are eligible for Medicare benefits pay for prescription drugs. ARxC opposes these changes imposing restricted drug formularies that would limit access to physician prescribed medications. These restrictions would especially impact chronically ill patients. The harsh changes would also impede access to new and innovative pharmaceutical and biomedical treatments. Higher premiums and co-insurance (out of pocket costs) could also increase. * Please call your Congressperson asking them to oppose any changes to Medicare Part D.


8.   In the last legislative session, the Rx in Reach Coalition of Georgia worked with Rep. Sharon Cooper to clarify language for HB 519, Step Therapy legislation, which provides an override or exception determination for doctor prescribed medications. This override or exception will allow doctors to prescribe the best drug for the patient’s medical needs. Step Therapy is a health insurance protocol that requires patients to first try a less expensive drug before moving up a ‘step’ to a more expensive, physician prescribed,  more effective and more expensive drug. This protocol of ‘failing first’ on a medication limits doctors to prescribe critical drugs needed and places patients in jeopardy of medical crisis and poor health outcomes. The Rx in Reach Coalition of Georgia will work to get this legislation passed in the next legislative session. We thank Rep. Cooper for her patience and support.


9.   ARxC continues to monitor developments of the American Health Care Act (AHCA). We oppose repeal of the Affordable Care Act (ACA) and will continue to work to ensure all patient protections for full affordable access to healthcare and prescription drugs for all Americans remains intact. We will work to improve the ACA. * Please call your Congressperson to improve the ACA and reject any repeal. (Go to for more information).