CMS Decision on Massachusetts Medicaid Waiver Protects Much-Needed Access to Healthcare

Statement of the American Lung Association in response to Centers for Medicare and Medicaid Services' Decision on MassHealth's Section 1115 Waiver Application:

"The American Lung Association is pleased that the Centers for Medicare and Medicaid Services (CMS) rejected provisions in MassHealth's 2017 waiver application that would have harmed low-income patients. Under the guise of "state flexibility," MassHealth asked for CMS approval of harmful policies that would have resulted in reduced access for many Medicaid enrollees, and increased out-of-pocket costs for this extremely low-income population. It would have allowed Massachusetts to proceed with a closed formulary – making it difficult for patients with lung disease and lung cancer to access the treatments their doctors believe are best for them. The Lung Association also applauds the decision to deny the state's request to reduce Medicaid expansion to residents making 100 percent of the federal poverty level and move those above this income level to the state's exchange.

"In comments filed with CMS in October, the Lung Association urged CMS to reject these provisions, as well as a provision that would have set up a duplicative state approval process for treatments already approved by FDA under its accelerated drug approval process. The Lung Association welcomes CMS’s clarification today that any FDA-approved treatment of covered outpatient drugs must be covered by Medicaid."