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Jay Gressing , Shire. Amendment to Section 1927 of the SSA Act regarding Medicaid Payments for Covered Outpatient Drugs. A Federal Legislative Solution to Improving Medicaid Coverage of Rare Disease Therapies. Jay Greissing Dir., U.S. Gov’t Relations and Public Policy September 19, 2014.

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jay gressing shire

Jay Gressing, Shire

Amendment to Section 1927 of the SSA Act regarding Medicaid Payments for Covered Outpatient Drugs

a federal legislative solution to improving medicaid coverage of rare disease therapies

A Federal Legislative Solution to Improving Medicaid Coverage of Rare Disease Therapies

Jay Greissing

Dir., U.S. Gov’t Relations and Public Policy

September 19, 2014

solution
Solution
  • Prohibit Medicaid plans from using restrictive step therapy protocols when:
    • The drug is prescribed for a rare disease; and
    • The rare disease is an FDA approved use
why should the community partner to petition congress
Why Should The Community Partner to Petition Congress?
  • Equity for individuals w/ rare conditions
  • Physician and patient preference
  • Innovation of and access to individualized treatments
  • Continuity of care