In November 2018, HHS proposed a rule that would have allowed Part D prescription drug plans under certain conditions to exclude drugs within a protected class. The proposed rule would have also allowed plans to require prior authorization for some prescribed drugs and would have removed restrictions against “step therapy.”
The proposed rule was seen by many people in the HIV community and in other chronic health care groups as a serious threat to Medicare beneficiaries’ health, well-being and life. Following strong opposition to the proposed changes, HHS issued a final rule that left the policy on protected drug classes largely intact and limited the allowances for prior authorization and step therapy.
AIDS United recognized the threat that the proposed rule posed for older adults living with HIV who had Part D drug coverage and was very active in opposing the proposed rule. AIDS United, and the partner organizations that make up its Public Policy Council, also saw opposition to the proposed rule as recognition of the need for more focused policy and advocacy on HIV and aging and on the urgent needs and concerns of older adults living with HIV. Acting on these recognitions, AIDS United initiated its HIV & Aging project, with support from Gilead Sciences.
An important component of the project was HIV and aging listening sessions conducted in summer 2019. The sessions were conducted in partnership with Public Policy Council member organizations and held in 12 cities across the country, including in Puerto Rico. Listening sessions were also held at AIDSWatch 2019 and the 2019 U.S. Conference on AIDS. The purpose of the sessions was to hear directly from older adults living with HIV about their experiences and their observations of and comments about services and service delivery to inform AIDS United’s policy and advocacy on HIV and aging issues. The participants reflected the diversity of people living with HIV in terms of race and ethnicity, sexual orientation, gender identity, lived experiences, and the various years of 50+. In the sessions, the facilitators heard directly the challenges and barriers that older adults living with HIV face and the gaps in services they experience.