Stay Informed

• An Update on Single Payor in California

  Mar 28, 2022

  

  The basic premise of making health care more affordable and simpler is at the core of our mission. This is the value we strive to bring our customers, members and clients every day. However, we do not believe that a state-run health plan would be less expensive or easier to navigate. A legislative analysis estimated the proposal could cost California approximately $400 billion annually – nearly double the current state budget – and would be financed by tax hikes on businesses, workers and high earners.^[1] This would happen on top of the problems with access, quality and affordability Californians would experience if the proposal was implemented.
  
  We launched an advocacy campaign against this bill that included an on-the-ground lobbying strategy, a multi-stakeholder coalition, and media efforts, all in partnership with our health care trade associations. Together with the California Association of Health Plans, we built a coalition that united the business community, the medical association, and hospitals across California against this bill. Our government affairs team worked with these groups to develop a lobbying strategy against AB 1400, including identifying targets, creating messaging and developing a unique strategy for each phase of the campaign as the bill moved through the legislature. The coalition also aired social and digital ads in Sacramento and in the districts of key legislators to complement the lobbying effort and raise awareness of just how this bill could negatively affect Californians. 
  
  In the end, the bill was blocked. Due to our advocacy efforts, the sponsor was forced to pull it from a scheduled vote by the Assembly as he knew the bill wouldn’t receive enough votes to pass. While this is a welcome development, our work doesn’t stop here. We will continue to work with our advocacy partners and lawmakers to implement health care reform measures that meaningfully address the endemic and systemic problems that plague affordability and accessibility in the health care system.

  [1] https://calmatters.org/newsletters/whatmatters/2022/01/health-care-taxes-california/

  
  
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• The Government Affairs Perspective on Anti-LGBTQ+ Legislation in States

  Mar 15, 2022

  

  CVS Health has a long history of support for the LGBTQ+ community. Unfortunately, in states across the country we have seen an increasing amount of anti-LGBTQ+ legislation or policy action that would cause harm to the LGBTQ+ community. These proposals do not align with our company’s commitment to inclusion and belonging.
  
  We are concerned by the bills being introduced and actions taken in dozens of states across the country.
  
  We have joined with many others in expressing our opposition to this legislative trend as well as affirming our long standing support for the Human Rights Campaign, which is actively fighting these proposals. They are by far, the strongest and most effective advocacy organization working against this type of legislation.
  
  Additionally, we are one of the 180 HRC business coalition companies to sign on to a business statement letter unequivocally opposing proposed legislation and actions we believe will cause harm to the LGBTQ+ community. The full text of that statement can be found below:
  
  Business Statement on Anti-LGBTQ State Legislation
  
  The companies joining this statement do business, create jobs, and serve customers throughout the United States. Our businesses strongly embrace diversity and inclusion because we want everyone who works for us or does business with us to feel included and welcomed as their true, authentic selves. Fairness, equal treatment, and opportunity are central to our corporate values because we care about our employees and the customers we serve. What’s more, these values also matter to our bottom lines. Inclusive business practices lead to more productive and engaged employees, increased customer satisfaction; and, ultimately, improved competitiveness and financial performance.
  
  We are deeply concerned by the bills being introduced in state houses across the country that single out LGBTQ individuals - many specifically targeting transgender youth - for exclusion or differential treatment. Laws that would affect access to medical care for transgender people, parental rights, social and family services, student sports, or access to public facilities such as restrooms, unnecessarily and uncharitably single out already marginalized groups for additional disadvantage. They seek to put the authority of state government behind discrimination and promote mistreatment of a targeted LBGTQ population.
  
  These bills would harm our team members and their families, stripping them of opportunities and making them feel unwelcome and at risk in their own communities. As such, it can be exceedingly difficult for us to recruit the most qualified candidates for jobs in states that pursue such laws, and these measures can place substantial burdens on the families of our employees who already reside in these states. Legislation promoting discrimination directly affects our businesses, whether or not it occurs in the workplace.
  
  As we make complex decisions about where to invest and grow, these issues can influence our decisions. America’s business community has consistently communicated to lawmakers at every level that such laws have a negative effect on our employees, our customers, our competitiveness, and state and national economies.
  
  As business leaders dedicated to equal treatment, respect, and opportunity for all - as well as to improving the financial and investment climate across the country - we call for public leaders to abandon or oppose efforts to enact this type of discriminatory legislation and ensure fairness for all Americans.

  
  
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• Protect Kansans’ access to affordable health care and life-saving medications

  Mar 08, 2022

  

  Colleague Mike Mayabi, Supervisor, Specialty Pharmacy, based in Lenexa, Kansas, penned this op-ed in The Topeka Capital-Journal.
  
  Imagine finding out that a loved one was diagnosed with a condition that completely changes their ability to live a normal life. As a pharmacy manager at CVS Specialty Pharmacy in Lenexa, I encounter families in these kinds of situations every day.
  
  The uncertainty can be overwhelming as they navigate how best to care for their families or friends.
  
  From my first role as a CVS Health customer service representative to my current pharmacist role, I know the importance of supporting patients on their path to better health. My team and I work tirelessly to ensure our patients — people with rare or chronic conditions who often require complex treatments and specialty medications — have access to medication and care when and where they need it.
  
  And, as a father who is raising a family here in Kansas, hearing the stories of children who are finally able to just be kids again because of their medication is especially
  rewarding.
  
  While access to these life-saving prescription drugs are critical for our patients, I have seen how the high list prices of these medications can be a burden on families. Specialty-drug costs are the fastest rising part of prescription-drug spending and now account for more than half of all drug spending.
  
  Affordable prescription drugs are a hallmark of good health, but every lever in the health care supply chain must work together to achieve affordability, so Kansans can access the care they need.

  
  
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• Industry Voices - The opportunity for telehealth beyond COVID: Expanding access to quality care

  Mar 04, 2022

  

  Throughout the pandemic, telehealth has provided access to quality care for millions of patients across the country. Even now, with the return of in office appointments, telehealth continues to broaden access to quality care—particularly in rural areas with fewer providers and for mental and behavioral health services.
  
  We are concerned, however, that tens of millions of Americans could lose access to telehealth care unless Congress acts. Without it, Medicare beneficiaries will lose access to telemedicine services when the public health emergency expires. And, Congress has already let an important consumer protection lapse at the end of 2021 which means consumers will no longer be able to use their Health Savings Account (HSA)’s for telehealth visits pre-deductible.
  
  The good news is that Congress and the Biden Administration can prevent this from happening.
  
  At CVS Health, we are proud to have been a part of the effort to expand access to care through telehealth. During the pandemic, we saw telehealth visits spike from 500,000 visits in 2019 to 17 million in 2020, and more than half (57%) of respondents to our 2021 Health Care Insights used a virtual visit to connect with a healthcare provider. Aetna observed significant rises in telehealth utilization—in 2020 telehealth accounted for 13 percent of all primary care visits, 6 percent for specialist visits, and a staggering 38 percent for mental and behavioral health visits.
  
  There are several actions Congress and the Administration can take and they include:

  • Allowing Medicare Beneficiaries to access health care from wherever they are by removing Medicare's outdated "originating site" requirements, which limit access to telemedicine based on patient location.
  • Permanently allow patients to initiate a telehealth visit without requiring a preexisting treatment relationship or in-person exam.
  • Making permanent the High Deductible Health Plan-HSA telehealth flexibilities provided by the CARES Act that expired at end of 2021, so patients can use their HSAs to cover telehealth services prior to reaching the deductible.
  • Allowing medical providers of telemedicine services to operate and serve patients across state lines.
  • Having CMS take steps to continue allowing providers who are providing telemedicine services from home to continue doing so after the PHE ends.
  • Permanently allowing "audio-visual" telehealth-obtained diagnoses to count toward risk adjustment in Medicare Advantage.

  Opponents of these changes may point to the absence of measurable data and the threat of increased costs, neither of which are valid. Telehealth providers, including CVS, do have data, and our statistics provide compelling reasons for advancing telehealth as a more permanent option for care.
  
  Specifically, over the last year of the pandemic, our data indicates that the total cost of primary care and specialty services among our customers has not increased despite continued telehealth use with the return of in-office visits. At the same time, our data shows that telehealth provided access to much-needed mental and behavioral health service, the demand for which has skyrocketed since the onset of the pandemic.
  
  We believe that access to telehealth can also be an important tool to reduce future health care costs by providing easier access to more regular management of chronic conditions like diabetes and kidney disease.
  
  At CVS Health, we are dedicated to helping people wherever and whenever they need us—whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient way. We do that by improving access, lowering costs and being a trusted partner.
  
  Telehealth helps us to meet these goals, and in turn, improves the health and wellbeing of the customers we serve.

  
  
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• U.S. House of Representatives Passes Organized Crime Legislation Actively Supported by CVS Health

  Feb 21, 2022

  

  The U.S. House of Representatives recently passed the INFORM Consumers Act, a piece of legislation that the CVS Health Government Affairs team and the Organized Retail Crime Division have been working hard to advance. The bill will require online marketplaces, such as Amazon, to collect and verify third-party sellers’ information, which will have a major impact on cutting down on the resale of stolen or counterfeit merchandise. We have been working with a coalition of retailers, consumer groups, manufacturers, and law enforcement officials who support these efforts to protect consumers and communities from the sale of counterfeit and stolen goods.
  
  The growth of organized retail crime has received significant national and local media attention with its increase in the last two years as criminal networks take advantage of the COVID-19 pandemic. This activity represents a serious threat to legitimate businesses of all sizes and subjects retail colleagues in particular to real harm. Since the start of the pandemic, CVS Health has experienced a loss of more than $200 million each year.
  
  In addition to requiring the verification of third-party sellers’ information, the legislation, will also require the disclosure of contact information to consumers who buy from high-volume third-party sellers. These basic transparency and accountability measures will help protect consumers from illicit goods, aid law enforcement in efforts to track organized crime, and make it harder for criminals to profit by selling stolen or counterfeit merchandise.  Now that it has cleared the U.S. House of Representatives, the legislation is headed to the Senate, where we seek to ensure its enactment this year.
  
  During his testimony before the U.S. Senate Committee on the Judiciary in November of 202, Ben Dugan, the Director of Organized Retail Crime at CVS Health said that, “CVS Health alone has experienced a 300 percent increase in retail theft from our stores since the pandemic began. The ease with which online sellers can open and close their sites, essentially undetected, is directly related to this increase in criminal activity in our stores.”
  
  Currently the marketplaces are not held responsible for the verification of third-party sellers on their platforms. Sellers can open and close sites to avoid being tracked by law enforcement, allowing criminal organizations to thrive in the anonymity of the internet. Because the largest marketplaces frequently are also distributing stolen goods, they protect these sellers when approached by law enforcement to assist with investigations.
  
  CVS Health also has been leading efforts to pass INFORM-like legislation in the states. More than 20 states legislatures are currently considering INFORM-like legislation. In addition, nearly a dozen state attorneys general have established organized retail crime task forces to increase collaboration between retailers, law enforcement, and prosecutors.
  
  The safety of our colleagues and our customers is paramount to CVS Health. By making it harder for criminals to easily sell stolen goods online, the INFORM Consumers Act will help curtail theft in retail stores.
  
  To learn more about the INFORM Consumers Act, click here.
  

  
  
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• Pharmacists can help keep prescription drugs affordable, if Michigan Legislature allows

  Feb 03, 2022

  

  Our colleague Anastassios (Tom) Aitas, RPh, Pharmacy Manager – CVS Specialty, based in Troy, Michigan penned an op-ed in the Lansing State Journal. Read his op-ed below.
  
  In over two decades working as a pharmacist, one principle has shaped my work: Do what it takes to serve patients.
  
  From rushing hemophilia medication for a parent so a child at sleep-away camp can get what they need to calling my patients who receive their medication in the mail to ensure they are storing it properly in the fridge, I take great pride in my work and my role in helping people get well and stay healthy.
  
  As a pharmacy operations manager for CVS Health, I see the life-saving impact of prescription drugs, which are critical for patients with complex or chronic conditions who require the specialty medications my team delivers. But I have also seen how the high list prices of these medications can be a burden on families. Last year, specialty medications accounted for more than half of all prescription drug spending.
  
  This is certainly the case in Michigan, where prescription drug pricing remains a priority for families and something they value when choosing a pharmacy to purchase the medications they need. Affordable prescription drugs are a hallmark of good health, but every level in the health care supply chain must work together to achieve affordability.
  
  In Michigan CVS Caremark, the pharmacy benefit manager of CVS Health, has made important gains in the fight for prescription drug affordability. We represent, and proudly serve, Michigan’s employers, unions, health plans and public programs by negotiating with big drug companies to save money for families. We fight for cost, quality, access and convenience for patients, who are too often forced to make difficult decisions about their prescription drug choices because of the high list prices big drug companies charge.
  
  We encourage the use of generics and more affordable biosimilar therapies, proven to lower costs and improve outcomes. In 2020, for example, CVS Caremark held prescription drug cost growth to just 2.9 percent. About one-third of our clients saw lower drug costs overall than in the prior year. Across Michigan, this is projected to save the state nearly $35 billion over the next ten years, putting money back in the pockets of families and struggling small businesses.
  
  At CVS Caremark, our patients get personalized support from a care team specially trained in complex conditions. We spend time with our patients to check dosage, ensure they know how to take their medication, remind them to refill, answer questions and help them manage side effects.
  
  In statehouses across the country, legislatures are weighing the value of pharmacy benefit managers in their state. As lawmakers in Lansing continue to evaluate proposals for addressing prescription drug pricing, it is essential they keep in mind the valuable role they play and the harm that would come from restricting the use of these tools to bring down costs.
  
  I take pride in the range of services we offer Michigan families. We not only want to save them money, but we also want the best outcomes for consumers in the state — whatever it takes.

  
  
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• New Year Brings New Protections from Surprise Medical Bills

  Jan 06, 2022

   

  The No Surprises Act was passed in December 2020 and after a year of implementation efforts and federal rulemaking, the law has gone into effect on January 1, 2022. This landmark legislation prohibits doctors and hospitals from sending patients surprise medical bills. 
  
  Surprise billing typically occurs when a patient receives care from out-of-network providers at an in-network hospital, or if a patient receives out-of-network emergency care. Surprise bill amounts vary greatly, and particularly egregious examples are often tens of thousands of dollars. While billing amounts vary, there is always a common theme: patients have no choice whether the provider is in or out-of-network in these scenarios, and those providing care seek higher reimbursement amounts by simply being out-of-network. In the two-year run up to passing the No Surprises Act, it was estimated that one in five patients had received a surprise bill and that nearly 20% of all emergency care generated a surprise bill.¹
  
  While several states have addressed surprise billing in some form in previous years, a majority of insured patients had no protections given that there were no federal protections for federally regulated employer coverage. That changed with the passage of the No Surprises Act, which specifically protects consumers by:

  • Prohibiting providers and facilities from sending surprise bills to patients for all emergency services and nearly all facility-based care,
  • Ensuring that cost sharing amounts equal what would be owed had the services been provided in-network,
  • Requiring insurers and out of network providers to negotiate payment disputes directly with one another so the patient is completely removed from the process, and,
  • Establishing an Independent Dispute Resolution process to settle lingering payment disputes, which again, keeps the patient out of the middle.

  While patients directly benefit by no longer being exposed to surprise bills, overall healthcare costs are also mitigated under the No Surprises Act. Federal rules accompanying the Act outline a process in which payments to out of network providers and hospitals should reflect median contracted rates. Tying facility and emergency services to contracted rates ensures that providers and hospital systems no longer get a financial windfall for being out of network, which will minimize consumer financial burden in the long run. Not surprisingly, providers and hospital systems that have profited from existing surprise billing practices are challenging the federal rules. Thus, while consumers are protected against surprise bills starting on January 1, the fight to lower overall costs will continue in the legal system and additional regulatory activity throughout 2022. 
  
  CVS Health strongly supports the consumer protections outlined in the No Surprises Act and subsequent federal rules establishing reasonable payment parameters. While implementing the new standards is operationally complex, our efforts will help ensure our members can access healthcare with fewer surprises in the new year. 
  
  _{1. https://www.kff.org/infographic/visualizing-health-policy-us-statistics-on-surprise-medical-billing/}

  
  
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• Melissa Schulman Discusses the Future of Healthcare on the Hill’s Strengthening America's Healthcare System Panel

  Dec 08, 2021

  

  On December 7, the Hill hosted a panel on Strengthening America’s Healthcare System to explore the current and future state of American healthcare and to discuss opportunities for improvement. Melissa Schulman, Senior Vice President of Government and Public Affairs at CVS Health, discussed ways all stakeholders can come together to improve and strengthen our health care system and to share how CVS Health is working every day to make health care more affordable, accessible and convenient.
  
  Watch the event here: https://thehill.com/event/581607-strengthening-americas-healthcare-system.

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• The Hill Again Recognizes Melissa Schulman as a Top Corporate Lobbyist

  Dec 06, 2021

  

  The Hill’s annual list of top lobbyists again named Melissa Schulman, CVS Health Senior Vice President of Government and Public Affairs, as a top corporate lobbyist in this year’s list.
  
  Determined by one of the nation’s largest and most prestigious political news outlets, this annual list recognizes “the people who wielded their connections and knowledge most effectively.” Click here to view The Hill’s Top Lobbyists 2021 list.

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• Lieutenant Governor Garlin Gilchrist of MI Receives COVID-19 Booster at Detroit CVS Health Pharmacy

  Nov 19, 2021

  

  Lieutenant Governor Garlin Gilchrist II (D-MI) recently received a booster shot at a CVS Health Pharmacy in Detroit. The Lieutenant Governor spoke about the availability of booster shot and the importance of getting the COVID-19 and flu vaccine. He thanked the CVS Health colleagues both at the store and across the state who have been on the frontlines throughout the pandemic.

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