Tell CMS: Preserve Medicare’s Six Protected Classes

Chuck Ingoglia
Chuck Ingoglia
Executive Director, Partnership for Part D Access

One of Medicare’s key patient protections – the six protected classes – is under threat by a new proposal from the Trump Administration. Feedback from the public will be critical in deciding whether or not they move forward — that’s why it’s essential that you let your voice be heard.

Threats to the Six Protected Classes Policy

When Congress designed the Medicare Part D program, it ensured that the full range of six classes of critically important drugs — medications for patients with mental health conditions, epilepsy, Parkinson’s Disease, lupus, HIV/AIDS, cancer, and organ transplants — would be guaranteed on all health plans for the patients who desperately need them.

Due to the unique and variable ways in which patients respond to different drugs, it has been widely recognized that doctors need to be provided complete discretion to prescribe the most appropriate medicines for their patients. In short, the ‘Six Protected Classes’ policy has long stood as a guarantee to patients that their access to all available medications for the most serious diseases would never be in doubt.

Today, that policy is under threat from a proposal by the Medicare agency (known as CMS). Under the proposed rule, CMS seeks to advance an extensive set of exceptions to the Six Protected Classes policy — far beyond what Congress has previously allowed. Doing so comes at the expense of the most vulnerable Medicare beneficiaries and directly contradicts Congress’ intent. Under these changes, thousands of Medicare beneficiaries taking these vital medications could be forced onto an entirely new drug regimen and be left to suffer with any complications that such a change would bring.

While the Partnership appreciates steps to address the cost challenge that threatens to limit patient access to prescription medications, we believe a better balance must be found that protects access to the full range of medications in the Six Protected Classes. Instead, the proposed rule presents new harm to patients by creating barriers to prescription medications for Medicare patients with chronic conditions, including patients who are already stabilized on a treatment within the Protected Classes.

How Can You Help?

Historically, the Medicare agency has been sensitive to the concerns raised by patients and their families during public comment periods — such as the one that is closing on January 25th on the proposed changes to the Six Protected Classes Policy. That’s why it’s essential that you let your voice be heard now.

Through the Partnership’s Action Center, you can easily send a letter to urge CMS to reconsider its recommendation. Through this platform, you can (1) send our draft letter directly to CMS, (2) incorporate our suggested text into your own letter, or (3) draft a letter of your own. Letters that you submit will be sent from your email directly to the agency.

It takes just two minutes to tell CMS to keep the existing Six Protected Classes — because when you limit drug choices, you threaten lives. Please send an email now.

About the Partnership for Part D Access

Founded in 2013, the Partnership for Part D Access is a leading coalition of healthcare stakeholders who are committed to maintaining beneficiary access to the full range of available medications under Medicare Part D. Specifically, we represent and care about individuals who would be negatively impacted by changes to Medicare’s Six Protected Classes policy. The Partnership counts several leading mental health groups among our membership.

What Do You Think?

  • What experiences and concerns about access to a variety of medications will you share with CMS?

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Author Bio

​With more than 20 years of experience in behavioral health, Charles Ingoglia has worked as a provider, advocate, and educator for government and public sector organizations. Ingoglia directs the federal and state affairs function of the National Council for Behavioral Health, and oversees practice improvement and technical assistance programs offered to more than 500,000 behavioral health professionals across the U.S. His efforts have centered on key issues such as parity, healthcare reform, and improving the experience of mental health and addictions care and treatment engagement.

Prior to joining the National Council, Ingoglia provided policy and program design guidance to the Substance Abuse and Mental Health Services Administration. He also has directed state government relations and service system improvement projects for the National Mental Health Association, served as a policy analyst for the National Association of Social Workers, and designed educational programs for mental health and addictions professionals at the Association of Ambulatory Behavioral Healthcare. He has worked in a transitional shelter with homeless persons and provided individual, group, and couples counseling at the Whitman-Walker Clinic in Washington, DC. Ingoglia is adjunct faculty at the George Washington University Graduate School of Political Management.

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