To memorialize the United States Congress to review the recent decision by the Center for Medicare and Medicaid Services (CMS) to allow for Step Therapy for Part B treatments.
Impact
SCR52 highlights the concerns surrounding the new CMS policy, asserting that Step Therapy could force patients to try less effective medications as a first step, possibly leading to worsening health conditions. It further argues that this practice might undermine the competitive benefits traditionally associated with different treatment options, failing to provide true patient choice and informed consent. The resolution calls for oversight by Congress to ensure patients' rights and access to necessary treatments are preserved under the updated regulations, asserting that a thorough review is essential to protect patient welfare.
Summary
Senate Concurrent Resolution 52 (SCR52) seeks to memorialize the United States Congress to review a recent policy change made by the Centers for Medicare and Medicaid Services (CMS) that allows the implementation of Step Therapy for Part B treatments. This resolution emphasizes the concerns of healthcare providers and patients regarding the potential negative implications of this policy shift, especially for treatments involving biologics designed for serious and life-threatening conditions. Given that CMS had previously prohibited Step Therapy for Medicare Part B, the reversal has raised alarms among those who believe it compromises the patient-doctor relationship and limits treatment options.
Sentiment
The sentiment surrounding SCR52 reflects a strong concern among legislators regarding the safeguards for patients under the new Step Therapy policy. Proponents of the resolution, including healthcare advocates and legislators, view it as a necessary intervention to protect vulnerable patients from regulatory changes that could exacerbate their conditions by limiting therapeutic choices. Critics, potentially those in favor of the CMS decision, may argue about the need for cost-containment measures in a changing healthcare landscape, leading to a polarized debate about access and quality of care.
Contention
Key points of contention associated with SCR52 include the implications for patient choice and the authority of providers to select appropriate treatments. Specific criticisms against the Step Therapy policy note that it could hinder specialized treatment for diseases such as cancer and autoimmune disorders, where individualized treatment plans are paramount. As such, the resolution represents a call to action from the state legislature to ensure that federal policy reflects a commitment to patient care without compromising essential treatment freedoms.
Expressing support for the Texas Health and Human Services Commission's application to the Cell and Gene Therapy Access Model through the Centers for Medicare and Medicaid Services and its Center for Medicare and Medicaid Innovation.
A JOINT RESOLUTION directing the Department for Medicaid Services to request guidance from the Centers for Medicare and Medicaid Services for Medicaid coverage on prescription digital therapeutics in the Commonwealth of Kentucky.
Urging the Congress of the United States and the United States Department of Health and Human Services to eliminate the Skilled Nursing Facility Three-Day Rule for Medicare recipients.
Coverage of medical services and prescription medications for the treatment of dementia required, and step therapy requirements for medical assistance modified.