PPTA Applauds the Florida Legislature for Preserving Medicaid Patient Access to Blood Clotting Factor

ANNAPOLIS, MD - The Plasma Protein Therapeutics Association commends the Florida legislature for allowing Medicaid recipients to continue to receive their clotting factor and the overlay services through the agency's hemophilia disease management program, rather than forcing them to switch to a managed care plan for their therapeutic needs.

In its recently completed 2011 Regular Session, the Florida House of Representatives proposed to require that all Medicaid recipients receive their services exclusively from a managed care organization in House Bill 7107. Hemophilia patients advocated for keeping the current method of accessing blood clotting factor through Medicaid fee-for-service, expressing concerns that the impact of the mandatory policy would impede their access to medically appropriate therapy. The legislature passed HB 7107, but with an exemption from mandatory use of a health maintenance organization (HMO) for accessing blood clotting factors for hemophilia patients.

Hemophilia already is well managed by Hemophilia Treatment Centers, and most Medicaid HMOs have not engaged in managing hemophilia like they have other diseases. HMOs do not possess general knowledge about hemophilia, how to treat it and best practices for the use of clotting factor therapies.

"This is a victory for patient access for Medicaid recipients in Florida and suggests that there is a growing understanding of the special nature and needs of patients with hemophilia for whom access to medically appropriate blood clotting factors is essential," said Julie Birkofer, senior vice president, North America, PPTA. "PPTA urges other states to follow Florida's lead and protect patients with hemophilia," Birkofer said.

"Florida's recognition of the quality care individuals with hemophilia receive in the current health system is extremely important given that the state is recognized across the country as a model state in setting health policy," Birkofer said. "Further, Florida recognized that when enrolling Medicaid recipients in managed care, as many states are now considering, it is important to make exceptions for those with extremely rare diseases that are currently managed well in the current health care system."

Plasma protein therapies, which include plasma-derived therapies and recombinant blood clotting factors (a biotechnology product), are biological products that are not interchangeable, and no generics or substitutions exist. These unique therapies are used every day to treat people with bleeding disorders such as hemophilia, which causes painful internal bleeding and debilitating joint damage; primary immunodeficiency diseases, which render the body defenseless from even the most common infections, often leading to pneumonia and other serious illnesses; and alpha-1 antitrypsin deficiency, also known as genetic chronic obstructive pulmonary disease (COPD). Additionally, a plasma protein therapy is used in critical care settings, when treating severe trauma, burns and during major surgery.

For more information, contact Kym Kilbourne at 443-458-4682.

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