(Boston) – State Rep. Garrett J. Bradley, D-Hingham, has filed legislation to promote continuity of care for multiple sclerosis (MS) patients, by requiring insurance coverage for prescription drugs designed to treat the disease. The coverage would extend to drugs that have already been prescribed and are being taken by the patient.
Rep. Bradley said, "Patients being treated for multiple sclerosis experience the disease differently, and require highly individualized treatment plans. By ensuring continuity of existing drug therapy, this bill will allow patients to focus on combating the disease itself, working with family, friends and doctors to maintain quality of life, mobility and independence for as long as possible."
Rep. Bradley explained that the bill is needed because if an MS patient’s health insurance plan does not cover the drug therapy that he or she has been taking, the patient may be forced to switch his or her therapy to receive coverage. This could happen if a patient changes health plans, and the new plan does not cover the drug, or because a plan drops coverage for that particular drug. Failure to cover an MS patient’s existing therapy may interrupt treatment and prevent patients from obtaining the drug they and their doctors have determined to be most effective, thus putting them at risk.
The bill would require specified Massachusetts health insurance plans to cover a disease modifying prescription drug to treat MS for a patient who is enrolled in a plan and has already been prescribed and been taking the medication. Health plans would include the Group Insurance Commission, to provide coverage for any active or retired employee of the Commonwealth, commercial health insurance plans, non-profit hospital services corporation individual or group plans, medical service corporation individual or group plans, and individual or group health maintenance organization plans. As a further safeguard to prevent disruption in treatment, these health plans would be prohibited from charging a patient higher cost-sharing for the drug than the plan would charge for any other disease-modifying MS drug.
The bill is currently awaiting referral to a legislative committee for review.