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Hemo Alliance Newsletters

MCR Update, January 2024

 

Member and Community Relations Update

“The January Blues”
by the Member and Community Relations Team

As you painfully know, every January payers shift the landscape and HTCs experience many obstacles to their pharmacy program. Benefits, formularies, prior authorizations, and prior authorization processes change. HTCs may lose patients to commercial specialty pharmacies and the narrowing of networks. We know that Alternative Funding Programs are on the rise and many patients have had a Copay-Accumulator or Copay Maximizer Program added to their benefits. The point being, January can give every HTC “the Blues” if they don’t have a plan in place to address these potential changes affecting their patients. We know every HTC has experienced this at some point. If you’re running into any of these issues, please reach out to your primary contact within the Member and Community Relations Team.

Here are examples of some information we may need:

  • Copy of insurance card
    • Identifies who the insurance company is and if it is a fully funded or self-funded plan.
  • Have you received an official denial?
    • If so, what is the reason for the denial? Include a copy of the letter if available.
  • Diagnosis and severity?
  • What is the product and dosage?

If an issue is affecting your HTC, it may be affecting others. By sharing your experience, we can help each other.

Also in this Issue…

· Welcome 2024

Advocacy Update
· Hemophilia Alliance 2024 Hill Day – The United Voices of Our Community

Washington Update
· Proposed Rule on Affordable Care Act Provisions Published
· Congress Puts Off Funding Bills Until March
· CMS Publishes Prior Authorization Final Rule

Legal Update
· Legal Team Update: Beware! Scammers Steal Funds from Department of Health and Human Services (HHS) Grant Recipients

Alliance Update
· Viva Engage! Hemophilia Alliance Virtual Networking Platform
· 2024 Meeting Schedules

Notes from the Community
· WFH 2024 World Congress taking place this April

Team Alliance Contact Information

We work for you! Please don’t hesitate to contact any of us with any questions or concerns:

NameEmailPhone
Jeff Blakejeff@hemoalliance.org317-657-5913
Jennifer Borrillo, MSW, LCSW, MBAborrillo@hemoalliance.org504-376-5282
Jeff Amondamond@hemoalliance.org608-206-3132
Jennifer Andersjennifer@hemoalliance.org954-218-8509
Angela Blue, MBAangela@hemoalliance.org651-308-3902
Karen Bowe-Hausekaren@hemoalliance.org717-571-0266
Zack Duffyzack@hemoalliance.org503-804-2581
Michael B. GlombMGlomb@ftlf.com202-466-8960
Johanna Gray, MPAjgray@artemispolicygroup.com703-304-8111
Kiet Huynhkiet@hemoalliance.org917-362-1382
Elizabeth Karanelizabeth@karanlegalgroup.com612-202-3240
Kollet Koulianos, MBAkollet@hemoalliance.org309-397-8431
Roland P. Lamy, Jr.roland@hemoalliance.org603-491-0853
Dr. George L. Oestreich, Pharm.D., MPAgeorge@gloetal.com573-230-7075
Theresa Parkertheresa@hemoalliance.org727-688-2568
Mark Plencnermark@hemoalliance.org701-318-2910
Ellen Rikereriker@artemispolicygroup.com202-257-6670