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Utilization Management Protocol Reform Measures Expected this Fall

posted: September 4, 2019

Legislation to address non-medical switching practices in the state is expected to be filed this fall. The measure seeks to prohibit switches for those covered by a health benefit plan and in the Medicaid program. Likewise, a bill to reform a new utilization management tool, commonly referred to as “copay accumulator programs” or “accumulator adjustment programs” is also nearing introduction. Under these programs, patients pay off the full value of their deductible after the value of their copay assistance runs out for the year. OAR holds that these costs prove unmanageable for many patients on expensive specialty medications.

OAR is looking for patient and provider stories to support our claims on why reforms are needed. Please contact OAR Government Affairs to share  your experiences by emailing hkazmark@wjweiser.com. OAR looks forward to updating members on these pieces of legislation as they progress through the legislature.