LRI Petitions HHS for Patient Protections in Insurance Coverage

The Lupus Research Institute’s Coalition of patient groups throughout the country were among 150+ groups that presented this joint letter to Secretary of Health and Human Services Kathleen Sebelius today. The letter requested improvements to the proposed Essential Health Benefits (EHB) rule issued by the Department of Health and Human Services (HHS) last month. In its November 26 issuance, the HHS had outlined the types of benefits that insurance plans must cover beginning in 2014.

Responding during the 30-day open comments period allowed by the HHS, we requested several stipulations to protect patients including:

  • Increased coverage of all or nearly all drugs in each class.
  • Guaranteed coverage of new drugs, but not at the expense of older ones.
  • Defined process for patients to petition for coverage of non-covered
  • medications.Limited cost-sharing of expenses to patients.
  • Defined framework for enforcing measures that prevent denial of coverage based on discrimination against particular conditions.

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