Insurer Agrees to Add HIV Drugs After Discrimination Complaint Filed

“While this action is certainly welcome, the fact remains that Harvard Pilgrim removed lifesaving HIV drugs from its coverage formulary, disrupted the treatment of people living with HIV, and violated the ACA’s nondiscrimination protections,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “This demonstrates the need for greater oversight of the health insurance industry and enforcement of the safeguards in place to protect patients against the abuse of insurers.”

Biden-Harris administration requires insurers to cover long-acting PrEP to prevent HIV

With low uptake of PrEP among the communities most impacted by HIV, this insurance coverage requirement with zero cost-sharing will help jumpstart the use of more effective forms of PrEP and lead to fewer HIV transmissions. We are grateful to the Biden-Harris administration for responding to our request to issue this guidance. Without it, we feel some insurers would continue to only cover daily oral PrEP, and not provide PrEP users with the choice they need. With up to a third of privately insured PrEP users still being charged cost-sharing, we must ensure that both federal and state regulators vigorously enforce PrEP coverage requirements.

Biden-Harris Administration Sides with Insurers & Fails to Take Steps to Lower Patient Costs for Prescription Drugs

Every day these rules are delayed is another day that insurers and PBMs are pocketing billions of dollars meant for patients who are struggling to afford their drugs. Coming from an administration that prides itself on supporting patients and lowering their prescription drug costs, this is a huge disappointment. While they have gone on record that they will issue these rules, the clock is ticking and there isn’t much time left.

Medicare Beneficiaries Can Now Access PrEP Without Cost-Sharing

We commend the Biden-Harris administration for increasing PrEP uptake using all the tools at its disposal. Patient cost-sharing has been a significant barrier for Medicare beneficiaries. With this new NCD, people on Medicare can join those with private insurance who can access PrEP without cost-sharing. Now we have to make sure these policies are properly implemented and enforced.

Senate Appropriators Maintain Funding for Domestic HIV and Hepatitis Programs

Instead of providing new investments in ending HIV by increasing funding for testing, prevention programs, such as PrEP, and life-saving care and treatment, House Republicans are again choosing to go through a worthless exercise of cutting programs that the American people depend on and will never pass.

House Proposes to Gut Ending HIV Programs—Again

Instead of providing new investments in ending HIV by increasing funding for testing, prevention programs, such as PrEP, and life-saving care and treatment, House Republicans are again choosing to go through a worthless exercise of cutting programs that the American people depend on and will never pass. These were purposeful decisions that are well below the agreed-upon budget caps. While we will vigorously fight these cuts, we look forward to working with the entire Congress in a bipartisan fashion on spending bills that can actually become law.

Who We Are

Monitors policies that impact the prevention and treatment of HIV, viral hepatitis, and other health conditions in the United States.

Communicates with members of the HIV, hepatitis, and other patient group communities on key policy issues that impact their access to healthcare.

Educates policymakers and members of the media about efforts to end both HIV and hepatitis in the United States and to improve access to quality and affordable healthcare for people with or at risk of serious or chronic health conditions.

Key Issues

Causes We Care About, and So Should You!

HIV

Promote necessary funding, programs, and policies to end the HIV epidemic in the United States

HEPATITIS

Promote necessary funding, programs, and policies to end viral hepatitis in the United States

HEALTHCARE ACCESS

Promote necessary funding, programs, and policies to end viral hepatitis in the United States

Facebook posts by @HIV+Hep

We urge U.S. Senate Health, Education, Labor and Pensions Committee Republicans @Senatehealth Senate Finance Committee to ensure that Donald J. Trump’s nominee to lead HHS.gov Robert F. Kennedy Jr., will uphold a commitment to #endHIV and to ensure that preventive svcs. remain covered w/$0 #costsharing & that #allcopayscount: bit.ly/4gboO2k ... See MoreSee Less
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Biden Admin Fails To Address Copay Accumulators As Term Ends: insidehealthpolicy.com/daily-news/biden-admin-fails-address-copay-accumulators-term-ends?utm_medi... ... See MoreSee Less
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Carl Schmid urged the Federal Trade Commission to prohibit #PBM use of #copayaccumulator progs & designation of some #Rx as “non-essential health benefits,” which allow PBMs & #insurers “to #profit at the expense of #patients who are having trouble affording their #Rx”: bit.ly/40Co81j ... See MoreSee Less
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HIV+Hep Asks Senators to Inquire on HHS Secretary Nominee’s Commitment to End HIV: bit.ly/4gboO2k ... See MoreSee Less
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We submitted comments to the Colorado Department of Regulatory Agencies on draft updated #PrEP guidance clarifying that #insurers must cover all @FDA-approved PrEP medications & related services without #costsharing or #priorauth: bit.ly/42iwMU2 ... See MoreSee Less
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