The Obama administration has to beef up the appeals process in Medicare Part D before it rolls out changes to the program's protected drug classes, the nation's largest senior lobby said Friday.
AARP tentatively backed parts of a proposed overhaul to Part D but urged caution when it comes to modifying protected-class status for some medications without adequate recourse for seniors who need better access to the drugs.
"While AARP agrees with the premise of the need to periodically reevaluate and potentially modify some or all of the protected classes — which should improve plan sponsors' ability to better negotiate prices with drug manufacturers — we strongly urge [regulators] to take additional precautions prior to implementation that will help ensure this change does not negatively affect enrollee access," the group wrote in comments Friday.
AARP's perspective will carry considerable weight with the administration, but so will the opinion of Republican and Democratic lawmakers who have roundly criticized the proposed changes as risking harm to beneficiaries.
The administration is facing a full-scale backlash from the healthcare world and Congress toward its proposal, which it argues will help reduce costs and overprescribing in Part D.
At stake in the fight are three classes of drugs that currently have "protected status" in Medicare: immunosuppressants, antidepressants and antipsychotic medications.
Regulations proposed earlier this year would remove those special designations, allowing insurers to limit the number of drugs they cover in each of the three classes. Three other types of drugs — cancer, HIV and anti-seizure meds — would retain protected status under Medicare.
Federal health officials have pointed to studies finding that the six protected classes make up a substantial portion of all drug spending in Medicare Part D. But AARP said the reform should not move forward without a better appeals process for patients.
"A streamlined, transparent and responsive appeals process would mitigate many of the legitimate access concerns that have been raised in response to this proposed change," AARP wrote.
The public comment period on the proposal ended Friday.