HIV+Hep in the News

Some HIV prevention clinics face major financial loss—but providers say Pittsburgh clinics are secure

Healthcare centers that provide the HIV-prevention medication PrEP in some states are facing financial peril after the maker of the drug slashed a crucial revenue stream. But centers in Pennsylvania and other Medicaid-expansion states will be less impacted by the change, Pittsburgh providers say. They expect to continue providing PrEP, a daily pill that prevents HIV with about 99% effectiveness, without disruption.

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Copay accumulator programs allowed in 2023 private insurance market In proposed rule

The Biden Administration is retaining a Trump-era policy allowing private insurers to prevent the value of manufacturer cost sharing assistance from being counted toward deductibles or out-of-pocket maximums in a recently-issued proposed rule governing health care plans. The decision not to revise or rescind the policy in the Centers for Medicare and Medicaid Services proposed rule on the Patient Protection and Affordable Care Act benefit and payment parameters for 2023 is a disappointment for manufacturers and patient groups, which have argued for change since the policy was proposed in 2020 for implementation in 2021. The deadline for comments on the latest proposed rule is 27 January.

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CMS proposes standardized options for 2023 in exchange rule

Every issuer participating in a federal exchange — or a state marketplace using the federal platform — must offer at least one standardized plan option starting in 2023 and those plans will receive differential display on healthcare.gov, CMS proposes in its draft exchange rule unveiled this week. The 2023 proposed Notice of Benefit and Payment Parameters was released Tuesday and CMS will accept comments for 30 days. The agency also plans to conduct network adequacy reviews in all states.

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