“Going to the WA Advocacy Summit is always a privilege. Being able to effect change to our health care law is an amazing thing,” says Heidi Barrett, Arthritis Foundation Washington state advocacy chair and a Platinum Ambassador. “Knowing this change will make the lives of the 1.3 million adults and 6,100 children in Washington with arthritis better is a humbling experience.”
2月20日，来自关节炎基金会、克罗恩病与结肠炎基金会和国家银屑病基金会的近60名倡导者在华盛顿的奥林匹亚联合起来，向立法者及其工作人员传授有关改革利用管理的立法。西澳倡导峰会包括一个上午的倡导培训、关于法案和国会当前环境的教育，以及社交媒体倡导。倡议者随后有机会将培训转化为实践，并与他们的立法者和/或他们的工作人员见面。
In a recently publishedstoryin the Everett Herald, Heid’s son, Levi, spoke about his experience of being forced to go through utilization management protocols despite the required drugs causing him to vomit and weakening his immune system. Utilization management – includingstep therapy(or “fail first”) protocols andprior authorization–is a set of formal techniques used by an insurance carrier or delegate of the insurer, such as a pharmacy benefit manager or third-party administrator. These techniques are designed to monitor the use, or evaluate the medical necessity, of appropriateness, efficacy or efficiency of health care services, procedures or settings.
The use of these programs often creates significant barriers to quality patient care, delaying treatment and contributing to negative patient outcomes. Utilization management protocols can lead to delays in access to the medications that offer the greatest potential medical benefit to people with arthritis. Because arthritis is a chronic, degenerative disease, delays in treatment can worsen disease progression and even cause permanent damage and disability. In some cases, patients may have no alternate therapy for an extended period if the drug initially prescribed was rejected.
House Bill 1879将确保利用管理协议更加透明和标准化。具体而言，该法案将确保利用管理协议以广泛接受的临床指南为基础，从而使医疗专业知识而不是成本决定要求。此外，HB 1879将为患者建立一个例外过程，如果尝试或继续使用一种药物会对依从性造成重大障碍，加重共病，禁忌或将降低患者实现或维持合理功能的能力。最后，该法案将批准或拒绝使用管理提交的时间统一为非紧急情况的3个工作日，紧急情况的1个工作日，对紧急情况不进行使用管理。
In all, Advocates had more than 50 meetings, all taking place in less than five hours.
“After leaving the lobby day at Olympia, I felt so empowered,” says Courtney Bruce, Arthritis Foundation Platinum Ambassador. “I felt very positive about the meetings we had with the staffers and representatives. They were very responsive to information we were bringing to them. They listened intently to stories of our loved ones. It was a great experience.”
HB 1879 has passed the Washington House of Representatives by a unanimous vote and is currently making its way through the state Senate. Washington Advocates can take action by sending an email to their member of the legislature through the action center or by clickinghere. We need your help!
Related Resources:
- 2019 Advocacy Summit – A Busy First Day Readies Advocates for a Day on Capitol Hill
- Advocates Share Their Stories to Empower Change
- 5 Ways to Advocate for Yourself