HIV+Hep in the News

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After complaints, health insurer agrees to cover common HIV meds

by | Dec 20, 2024

“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 nondiscrimination protections [of the Affordable Care Act (ACA), or Obamacare],” said Carl Schmid, executive director of the HIV+Hep. “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.”

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How to break down barriers in HIV care

by | Dec 18, 2024

“Over a million people in the United States have HIV,” says Carl Schmid, Executive Director at the HIV+Hepatitis Policy Institute. According to HIV.gov, of those approximately 1.2 million patients, around 13% “don’t know it and need testing. People don’t think about HIV as much as they used to,” continues Schmid. “They think it’s a solved issue, but no—we still have over 30,000 new infections every year.” Testing and timely access to treatments are essential. “To remain healthy, patients must stay on their medication, which is a lifelong commitment,” Schmid says. “While we have great drugs, getting them to the people who need them remains a challenge. Numerous barriers exist—socioeconomic barriers, insurance barriers, and issues with health coverage. Many people can’t access the drugs they need due to cost, formulary restrictions, or lack of coverage.”

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Harvard Pilgrim will continue covering HIV drugs, following state investigation

by | Dec 17, 2024

The HIV + Hepatitis Policy Institute filed its initial complaint with the bureau in November, alleging that failing to cover the broadly accepted treatment regimens would discourage people with HIV from enrolling in Harvard Pilgrim’s coverage and would violate federal law. The Affordable Care Act mandates that insurers provide “appropriate access to drugs that are included in broadly accepted treatment guidelines and that are indicative of general best practices at the time.”

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Health care advocates accuse Harvard Pilgrim of discrimination against HIV patients in Maine

by | Dec 13, 2024

Several physicians and health care advocates are accusing Harvard Pilgrim of discrimination against HIV patients in Maine and have filed a complaint with the Maine Bureau of Insurance. According to the complaint, Harvard Pilgrim’s plans for 2025 will no longer cover two of four recommended drugs that treat HIV. The complaint said that one drug, Biktarvy, is prescribed to nearly half of all HIV patients in the U.S.

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Health advocates say private insurance companies in Minnesota are discriminating against HIV patients

by | Dec 5, 2024

In Minnesota for 2025, private insurance companies have put most HIV medicine on the highest tier. Carl Schmid said this can deter people away from applying for a health plan. “Because it’s on a high tier it’s like $700 in some of the plans, so you could be paying the insurance company more than what they’re paying for the drug,” he said. According to the ACA, health insurance companies cannot discriminate based on a person’s health.

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