Progress on Oregon Health Plan coverage for psoriasis
Low-income Oregonians are coming closer to regaining access to treatment for psoriasis
On April 22, 2004, the National Psoriasis Foundation came closer to scoring a victory in its home state. A subcommittee of the Oregon Health Plan (OHP) recommended that funding for patients with severe psoriasis be reinstated. The vote followed the Jan. 1, 2004, ending of OHP treatment for all types of psoriasis.
OHP is the umbrella name for several federal- and state-funded health insurance and related programs, principally Medicaid, that help tens of thousands of low-income Oregonians access health care. Access to treatment for psoriatic arthritis is still available.
The Health Outcomes Subcommittee of the Oregon Health Services Commission voted unanimously to recommend that OHP reinstate treatment for patients with serious psoriasis. National Psoriasis Foundation volunteers and staff observed the deliberations.
"The April 22 vote was one step along the long road to regaining access to psoriasis treatment for many Oregonians via the Oregon Health Plan," says Robert Gassner, director of advocacy at the National Psoriasis Foundation. "During the coming months, Psoriasis Foundation staff and volunteers will track the process, keep Foundation Members informed and look for opportunities to increase access for patients."
Psoriasis Foundation mobilizes to reinstate funding
Every two years the Oregon Health Services Commission, a committee of citizens advised by staff, reviews a "Prioritized List" of which conditions and treatments OHP will pay for and which it will not. During the last review, the Commission recommended that OHP not pay for psoriasis treatment.
To help counter the original recommendation, Members of the Psoriasis Foundation (including patients, family members, dermatologists, and others) wrote letters, observed meetings of the Commission and its "Health Outcomes" Subcommittee, and sent information to the citizen members and staff of both groups.
Tracking the progress
By the end of June 2004, the Health Services Commission will recommend what the Oregon Health Plan should and should not pay for beginning in the fall of 2005. This recommendation eventually will go to the federal Centers for Medicare and Medicaid Services.
If the recommendation survives, in the fall of 2005 OHP will provide access to treatment for the following psoriasis patients:
- at least 20 percent body surface area involvement
- and/or hand, foot, or mucous membrane involvement with moderate functional limitation defined as limitations not requiring external mechanical or human assistance
For more information, please contact the National Psoriasis Foundation at 800.723.9166.
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