89R16409 BPG-D
By: Simmons H.C.R. No. 103
CONCURRENT RESOLUTION
WHEREAS, Cell and gene therapies can transform the lives of
people living with rare and severe diseases that are difficult to
treat; and
WHEREAS, A rapidly growing class of one-time treatments, CGT
can correct underlying causes of such conditions as sickle cell
disease, alleviating symptoms and halting progression; these
treatments have the potential to reduce health care spending over
the long term by addressing the underlying causes of disease,
reducing the severity, and decreasing health care utilization; and
WHEREAS, The high upfront cost of these treatments makes it
difficult for state Medicaid agencies to pay for them; accordingly,
the CGT Access Model was created to improve health outcomes for
people with Medicaid by supporting agreements between states and
manufacturers that will provide for treatments within a framework
that lowers prices for states and ties payment to outcomes; and
WHEREAS, A voluntary program under the Center for Medicare
and Medicaid Innovation of the federal Centers for Medicare and
Medicaid Services, the CGT Access Model tests whether a CMS-led
approach to developing and administering outcomes-based agreements
for cell and gene therapies expands Medicaid beneficiaries' access
to innovative treatment, improves their health outcomes, and
reduces health care costs and burdens to state Medicaid programs;
under the model, CMS and pharmaceutical manufacturers would
negotiate a set of key terms, including pricing and outcome
measures, that would form the basis for individual contracts
between the manufacturer and participating states; participating
states would receive CMS technical assistance and funding; and
WHEREAS, The Texas Health and Human Services Commission has
evaluated the CGT Therapy Access Model and has applied for
admission in order to test its innovative payment and service
delivery models to reduce program expenditures while enhancing the
quality of care; and
WHEREAS, Cell and gene therapies offer potentially
life-changing benefits, and their use for Texas Medicaid patients
with rare and severe diseases holds the possibility of improving
health outcomes while lowering long-term costs to the state; now,
therefore, be it
RESOLVED, That the 89th Legislature of the State of Texas
hereby express 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.