Covered California Takes Steps To Improve 2016 Rx Drug Coverage

Covered California is taking steps to finalize prescription drug benefits for its 2016 health plans, Capital Public Radio’s “KXJZ News” reports.
Details of Actions

According to exchange spokesperson Dana Howard, Covered California is considering both accessibility and affordability as it develops plans for prescription drug coverage.

Specifically, the exchange board last week voted to:

-Define what drugs will be placed in specific pricing tiers;
-Require at least one drug for a certain condition to be in a lower tier; and
-Require health plans to post drug pricing information online (Bartolone, “KXJZ News,” Capital Public Radio, 3/9).

The exchange board also proposed several ideas aimed at increasing transparency and access for its 2016 plans, including:

-Allowing consumers to obtain in-person assistance at no additional cost;
-Establishing a dedicated pharmacy customer service phone line; and
-Sharing information on the availability of drugs not included in formularies.

Meanwhile, the exchange also has requested that insurers submit reports detailing the effect of specialty drug price caps on premiums. Using that information, the exchange plans to develop recommendations regarding specialty drug caps ahead of its May board meeting (Exchange Board report, 3/5).

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