Advocacy is a core component of the GTMRx Institute’s mission and vision, and our policy positions are aimed at helping to advance acceptance and recognition of the importance of creating a systematic, evidence-based approach to medications and their rational use—comprehensive medication management (CMM). To ensure the stability and success of CMM services, we regularly advocate to the Centers for Medicare and Medicaid (CMS), members of Congress, open forums/requests for information and policymakers.
GTMRx’s advocacy efforts and letters along with policy recommendation documents include:
On November 8 the GTMRx Institute joined a coalition of employers, health care providers and patient advocates in urging Congress to support strong pharmacy benefit manager (PBM) reforms this year. Needed reforms include commonsense changes to hold PBMs accountable to fair market practices when partnering with our nation’s employers — small, medium and large — who are the largest customers of PBMs. PBM transparency, as with transparency across all healthcare stakeholders, remains one component of the goal to lower costs and ensure access to affordable, quality care. However, PBM transparency alone will not be enough to address the issues employers face in assuring that people covered by employer-sponsored plans are truly receiving the best care at the best price.
Read the entire letter to Senate leadership here.
Re: HHS Notice of Benefit and Payment Parameters for 2024 Proposed Rule, CMS-9899-P RIN 0938-AU97. GTMRx has submitted formal comments to HHS urging the department to adopt as part of the Prescription Drug Essential Health Benefit, medication optimization through the use of comprehensive medication management in all marketplace (Obamacare) health plans. GTMRx is hopeful to begin a dialogue with the Center for Consumer Information and Insurance Oversight (CCIIO) to incorporate CMM in such plans in 2024.
Oral testimony prepared by GTMRx for the North Dakota House Industry, Business and Labor Committee regarding HB 1095 on January 11, 2023.The North Dakota legislature is hearing legislation on codifying comprehensive medication management (CMM) into law. On January 11, 2023, the GTMRx Institute submitted testify in favor of this bill. The GTMRx Payment & Policy Workgroup leadership is working closely with the ND Insurance Commission to support passage into the Senate.
Follow-up Response to CMMI in Reference to the White House’s October 14, 2022 Executive Order on Lowering Prescription Drug Costs for Americans. The Administration is taking immediate action to implement parts of the Inflation Reduction Act of 2022, which will benefit Medicare beneficiaries with a cap for out-of-pocket costs at the pharmacy and for insulin. Combining these changes with CMM services could further reduce unnecessary spending, while increasing care quality.