planning

Well, that certainly doesn’t sound like a band name.  Neither does “An Act promoting continuity of care for multiple sclerosis treatment,” but that’s what I’ll be talking about here.  In Massachusetts, State Representative Sean Garballey (D-23^rd Middlesex County) reintroduced this bill today in the State’s House of Representatives.  It needs a co-sponor or twelve.

So, what’s in this bill?  Well, first of all, this was originally introduced prior to the outcome of the Presidential election (remember how I used the word “reintroduced”).  This bill fills in some serious coverage gaps with regards to MS disease modifying therapies (DMTs).  If you have MS (or know someone who does), then you’re probably aware that these therapies are not cheap, even with insurance. There’s a long, long list of reasons for that, but for the sake of sanity, it’s sufficient to simply point out that a majority of MS DMTs are biologics and need to be created/grown in a lab, and that takes time, training and a good deal of money.  They’re not drugs in the “generic Tylenol” kind of way.

We know that health insurance companies don’t like the word “expensive.” You’ve likely heard horror stories of cancer patients being dropped by their insurance carriers for being just that.  Some other things insurers can do is limit your treatment options, and there are some that are trying to do just that in MA. This can mean that if an MS patient gets a new job with new insurance, they could be forced to change their MS treatment, based solely on the formulary of their new insurance plan.  This is dangerous and ultimately, far more costly in the long run. In more technical terms:

“This legislation will ensure that insurance coverage for MS disease-modifying treatments is not interrupted due to non-medical insurance policy/formulary decisions.  This bill also provides that the continued coverage for the MS treatment (outside the formulary) shall not be subject to any greater deductible, coinsurance, copayments, or out-of-pocket limits than any other disease-modifying prescription drug for multiple sclerosis provided by the insurer.” –Jake Krilovich, National MS Society

Simply put, it’s a state law that would bar insurance companies from forcing MS patients to use DMTs that don’t work for them. It also bars insurance companies from essentially discriminating against an MS patient by slapping them with higher payments for their disease modifying therapy.

Want to help make sure this is passed, especially seeing as the ACA’s pre-existing conditions laws are being dismantled? Here’s what you can do.

If you live in Massachusetts

1. Find out who your state (NOT federal) Senator and Representatives are.  If you’re not sure who they are, check out www.wheredoivotema.com.
2. Drop them a line- call or email and ask them to support HD 2060, “An Act promoting continuity of care for multiple sclerosis treatment.” If you happen to have a personal experience with MS, go ahead and tell them.
3. Drop Sean Garballey a line and thank him for introducing the bill.
4. Do it again in a week or so if you haven’t heard back.

If you don’t live in Massachusetts

1. Drop Sean Garballey a line and thank him for introducing the bill.
2. If you think his bill would be something your state should introduce, call your state reps and see about getting them to draft a similar bill to Sean’s.
3. Email MA reps for friends and family members who reside in MA. You’re not a resident, but you’re related to one, and they may listen to you as a result.

What happens for this year in terms of shows is up in the air, but at the very least, this is one thing we can do to make the world a slightly less dark.