Ohio General Assembly
OBDC constantly monitors the legislative landscape at Ohio’s Statehouse.
Right now, we are very busy monitoring a few pieces of legislation.
SB243 – Step Therapy (Companion House Bill 443) – Senate Bill 243 – Summary | The Ohio Legislature
SB135 – Spec Tier/Co-Pay – Senate Bill 135 – Documents | The Ohio Legislature
SB129 – Prior Auth – https://www.legislature.ohio.gov/legislation/legislation-summary?id=GA131-SB-129 PASSED 2016!
OBDC is also interested in monitoring the findings and work of the Joint Medicaid Oversight Committee and a stakeholder group formed for the transition of hemophilia patients into Medicaid Managed Care.
If any of these issues are important to you, or you would like more information, fill in the form below to contact Randi Clites, OBDC Advocacy Coordinator.
Ohio Department of Insurance
The mission of the Ohio Department of Insurance is to provide consumer protection through education and fair but vigilant regulation while promoting a stable and competitive environment for insurers. OBDC ensures that people with bleeding disorders are protected in the following ways:
- Access to HTCs – We are working to make sure that all public and private insurers include each of Ohio’s hemophilia and thrombosis treatment centers in its list of network providers.
Ohio Department of Health
The mission of the Ohio Department of Health is to protect and improve the health of all Ohioans. OBDC works hand-in-hand with ODH to make sure they are doing as much as they can to protect and improve the health of Ohioans living with bleeding disorders in the following ways:
- Protecting the Adult Hemophilia Insurance Program – We work with key ODH staff and state legislators to try to maintain funding allocated to the HIPP program. HIPP helps with payment of health insurance premiums for persons over 21 years of age, with hemophilia or a related bleeding disorder, who meet the eligibility criteria as defined in Ohio Administrative Code 3701-43-16.1.
Ohio’s Medicaid program provides health coverage to families with low incomes, children, pregnant women, and people who are aged, blind, or who have disabilities. Many families affected by a bleeding disorder are covered through this program, so the OBDC speaks for them on the following issues:
- Warning against reductions in Medicaid reimbursements – The cost of prescription drugs is one of the largest areas of expense for any state. Therefore, Medicaid reimbursement rates for drugs are often looked to as an area to cut costs. OBDC is trying to educate decision-makers on the disastrous effect that lowering reimbursement rates for the extremely expensive factor replacement therapies could have for people with bleeding disorders. If pharmacies lose money by dispensing factor products, there isn’t going to be much of an incentive for them to serve people with bleeding disorders.
- Carving out hemophilia from Medicaid managed care – As healthcare costs continue to rise, the trend for states is to move Medicaid toward a managed care model. With the extremely high cost of drug therapy for hemophiliacs, this could potentially be bad news for the bleeding disorders community, so OBDC has and will continue to ensure that hemophilia treatment is not included under Medicaid managed care.
Ohio’s Largest Private Insurers
OBDC plans to develop relationships with key decision-makers in each of Ohio’s largest private insurers, including companies such as Medical Mutual, Aetna, Unitedhealthcare, and Anthem, to ensure that their policies and practices aren’t harming families affected by a bleeding disorder. Right now, we are specifically working toward:
- Ensuring access for patients of all factor replacement therapies and Hemophilia Treatment Centers (HTC) – Private insurers are increasingly using “preferred drug lists” to help contain costs of prescription drug benefits and narrowing the provider markets. OBDC will be educating administrators at these companies about the reasons why people with bleeding disorders cannot be forced into using one or two drugs they handpicked for cost-containment reasons.