Amendment #1356 to H4700

Biennial Review of Medications and Forms of Treatment for Sickle Cell Disease

Ms. Fluker Oakley of Boston moves to amend the bill by adding the following sections:

Section XXXX. Chapter 118E of the general laws is hereby amended by adding the following new section:-

Section 80. (a) Every two years and no later than November 15 of each such year, the executive office shall complete and publish a report that details the findings from a review based on data collected for the prior two years as required under this section. The purpose of the review is to determine if the available covered medications, treatments, and health care services are adequate to meet the needs of such enrollees, and whether the division should seek to add or facilitate access to additional medications, treatments or services. Each report shall detail the results of the review, and shall include any recommendations for improvements in the delivery of health care services to MassHealth enrollees with a diagnosis of sickle cell disease.

(b) Each review shall include, without limitation, the following:

(1) the extent to which healthcare transitional programs or services offered by covered by the division prepare, transfer and integrate emerging adults with sickle cell disease into the adult care setting;

(2) the extent to which providers of emergency medical services to MassHealth enrollees are adequately trained and otherwise prepared to treat and manage sickle cell patients presenting with vaso-occlusive crises, including without limitation the extent to which such providers follow clinically validated algorithms and protocols regarding such treatment and management;

(3) the number of people with sickle cell disease (SCD) who had a hospitalization or emergency department visit with a vaso-occlusive episode or pain crisis more than twice a year, including the average length of stay for such visits.

(c) When conducting each review required under this section, the executive office shall solicit and consider input from the general public, with specific emphasis on receiving input from sickle cell patients as well as persons or groups with knowledge, experience or specialized expertise in the area of sickle cell disease treatment. The executive office may hold one or more public hearings for the purpose of soliciting such input no later than April 31 of each year that the review is conducted.

(d) Each report required to be completed under this section shall be filed with the clerks of the senate and house of representatives, the joint committee on health care financing and the senate and house committees on ways and means, and shall also be published on the division’s website in a manner accessible by the general public.

Additional co-sponsor(s) added to Amendment #1356 to H4700

Biennial Review of Medications and Forms of Treatment for Sickle Cell Disease