P4HA is actively working with our members to develop and advocate for Federal legislation that will improve medication adherence and patient outcomes, while saving money by keeping patients healthier and avoiding more costly medical care. Below is a list of legislation on which we are currently working. We invite all interested parties to join our efforts.
real-time benefit tools
h.r. 3415 (116th) | h.r. 3408 (116th) | senate finance prescription drug pricing reduction act 2019
P4HA is actively working with both the House and Senate on legislation that requires Medicare Prescription Drug Plans to implement a real-time benefit tool that can provide prescribers with patient-specific, real-time formulary and benefit information. This information can be used to facilitate discussions about cost expectations before a patient reaches a pharmacy counter and potentially abandons a script, helping to curb primary non-adherence.
Past Legislative Successes
coordinating medical and pharmacy care- data sharing
medication synchronization- gao study
H.R.3447 | S. 870 | h.r. 1892 (115th) Bipartisan budget act 2018
p.l. 115-123 (sect. 50354 data sharing; Sect.50351 med sync)
In Medicare fee-for-service (FFS), medical and pharmacy data exists in silos. P4HA worked with Congress to link medical and pharmacy data to improve the use of medicines by providing Part D Plans with claims data from Medicare Parts A and B.
P4HA also worked with Congress to secure language ordering a GAO study of medication synchronization effects on patient outcomes.
Both provisions were signed into law as part of the Bipartisan Budget Act 2018 in February 2018.
electronic prior authorization- reducing primary nonadherence
H.R. 4841 | h.r. 6 (115th) Support act | p.l. 115-271 (Sect. 6062)
Electronic prior authorization (ePA) is the automated process of exchanging patient health and medication information required to help the patient’s prescription coverage plan make a coverage determination. P4HA worked with Congress to encourage broader adoption of ePA in Medicare Part D as a means to reduce primary medication non-adherence, reduce provider burdens, and improve patient access to prescribed medications. The legislation was signed into law as part of the SUPPORT for Patients and Communities Act in October 2018.