U.S. Senators John Curtis (R-UT) and Jacky Rosen (D-NV) introduced the Protecting Patient Access Act, bipartisan legislation to protect patients’ access to their preferred doctors and lower out-of-pocket drug costs. The bill would allow patients to change insurance plans mid-year if their doctor or other medical provider is no longer in-network, or if their out-of-pocket drug cost increases during the year. This would apply to Medicare prescription drug plans, Medicare Advantage, and individual market plans for patients of all ages.
“When a Part D plan makes significant changes between enrollment periods, seniors shouldn’t be forced to live with a plan they didn’t choose for the rest of the year,” said Senator Curtis. “By opening enrollment following a significant plan change, our commonsense, bipartisan legislation ensures American seniors are insulated from uncertainty and receive the care they need and have paid for.”
“Under the current system, Nevadans can be caught off-guard by mid-year increases to prescription drug prices and changes to their in-network doctors. It’s just common sense to allow patients to change their medical insurance to continue seeing the doctors they trust and protect them from getting priced out from the life-saving medicine they need,” said Senator Rosen. “It is crucial that Nevadans have access to the best and most affordable health care options available, which is why I am proud to introduce this bipartisan bill. I promise to continue working across the aisle to ensure that everyone has access to the life-saving care that they need.”
“The American Academy of Family Physicians strongly supports the Preserving Patient Access Act, which will help patients prioritize their health and ensure relationships are maintained with trusted physicians and that access to necessary medications go uninterrupted,” said Sarah C. Nosal, MD, FAAFP, President of the American Academy of Family Physicians. “This legislation will allow patients relying on Medicare to change plans when a physician moves out of network or when drug coverage changes and becomes unaffordable. It will also protect continuity of care, strengthen the patient-physician relationship and help Medicare patients stay on track with the care and treatments needed to be well and stay healthy.”
Background:
The Protecting Patient Access Act would help ensure patients are not locked into health plans that no longer meet their health care needs after enrollment. The legislation creates a special enrollment period for Medicare Advantage, Medicare Part D, and individual market enrollees when their plan makes significant mid-year changes—such as removing a trusted doctor from its network or dropping coverage for a prescription drug they rely on. By allowing beneficiaries to switch to a plan that better meets their needs, the bill protects continuity of care and helps patients maintain access to the providers and medications they depend on.
The full text of the bill is available here.
