The full letter is available below.
PIPC Oregon Letter on QALYs.pdf |
PIPC Submits Letter to HHS on Oregon Medicaid Waiver to Ration Care for Children with Disabilities9/30/2016
Today, Partnership to Improve Patient Care (PIPC) Chairman Tony Coelho sent a letter to the Department of Health and Human Services (HHS) expressing concerns with a proposed extension of Oregon's Medicaid Health Plan Extension. Currently, Oregon has a unique waiver from “EPSDT” – a foundational principle of Medicaid that makes health care for children a national priority, and specifically requires coverage of “all medically necessary diagnostic and treatment services." The system underlying the Oregon Health Plan is a prioritized list of services, that uses quality-adjusted life-years (QALYs) to help rank treatments in order of importance. High ranked treatments are funded; low ranked treatments are automatically denied regardless of medical necessity. In the letter, Chairman Coelho states that "As chair of PIPC, I have made it my ministry that patients and people with disabilities must have a meaningful voice in the development of health policies, particularly in the discussion about what constitutes “value” in health care. Yet, what I have learned from the families of autistic children in Oregon is that they are not at the table and their perspectives of valued services for their children are not being taken into consideration... I have been very vocal, along with all my colleagues representing people with disabilities, about my concerns with the use of measures of cost effectiveness and particularly quality-adjusted-life-years (QALYs) to determine value. It has been our experience that these types of measures of value often conclude that we are not worth it, that our lives are not valuable. As a result, we are denied access to needed health care. In this case, Oregon’s policies are withholding access to medically necessary care for needy children, which is most egregious." The full letter is available below.
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