The following editorial from Mike Lee, COO of Evergreen Health, Secretary of RWC-340B was posted in the New York Daily News on September 16, 2020
Over the last six years, New York has engaged in an historic effort to end the AIDS epidemic in the state. Health care providers have worked tirelessly to realize the vision that Gov. Cuomo laid out in 2014 to end the epidemic. Sadly, that progress has all been put in jeopardy by a misguided provision in this year’s state budget that would pull the rug out from under the very same safety net providers that have been fighting back HIV/AIDS.
The issue revolves around a recommendation from the governor’s Medicaid Redesign Team II (MRT II) and the federal 340B Drug Discount Program. This program protects health clinics and other safety net providers from drug price increases and enables our patients to have access to pharmaceuticals at discount prices. It is a lifeline for our patients and absolutely vital to our ability to serve them.
Unfortunately, in the pressure to finalize the budget as New York approached the peak of the COVID-19 pandemic, a little-noticed provision was included that would carve out this critical pharmacy benefit from the state’s Medicaid managed care program and shift payments to fee-for-service reimbursement. The consequences of this accounting maneuver would devastate HIV/AIDS clinics receiving funding through the Ryan White program, federally qualified health centers, safety-net hospitals and other safety-net providers in the 340B program.
New York has made great strides to end the AIDS epidemic with a multifaceted approach of testing, treatment and prevention. Of course, treatment and prevention goes beyond what might traditionally be thought of as health care; it includes operating food pantries, providing transportation, and running harm reduction programs. Each one of those areas has utilized 340B savings to move closer to this goal.
To really understand what we do as safety-net providers, try to put yourself in the shoes of a person who finds out they’re HIV positive. Treatment doesn’t mean giving them a pill and sending them on their way. These are high-need patients that more often than not have many challenges in their lives that need to be addressed. How can you tell someone to take a pill every day if they don’t have a place to live or food to eat? 340B makes the viral suppression rates we’ve all achieved possible as we address all the patient’s needs.
And so, we must ask the painful question: As we look towards 2021, is New York’s “end the epidemic” goal in ending?
This change comes at a time when these same health care providers have also been fighting back the coronavirus. It’s unconscionable that we who are trying to do the best we can to serve our patients during a pandemic — and a time when racial equity is at the forefront of our efforts — have to fight off so many threats coming after our organizations and the patients we serve.