HIV+Hep in the News

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RI is close to eliminating new HIV infections. Why an insurer’s decision could change that

by | Nov 26, 2024

Earlier this month, Philip Chan and Amy Nunn co-signed a letter sent by the HIV+Hepatitis Policy Institute to Rhode Island’s Health Insurance Commissioner Cory King. The letter calls Harvard Pilgrim’s decision to curtail coverage of HIV medications “discriminatory.” It argues that Harvard Pilgrim’s proposed plans do no meet regulatory standards–both state and federal–by failing to provide essential health benefits. The letter also urges the Office of the Health Insurance Commissioner to bring Harvard Pilgrim “in line with HIV treatment guidelines.”

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Harvard Pilgrim, Medica face HIV discrimination complaints

by | Nov 20, 2024

The HIV + Hepatitis Policy Institute filed five discrimination complaints to state insurance commissioners against Medica and Harvard Pilgrim. The organization claims the insurers try to ensure enrollment remains low among people with HIV, and that the insurers place HIV brand-name and generic drugs on the highest cost formulary tier. It is also alleged the plans do not cover drugs recommended by national guidelines, and the insurers don’t meet health benefits benchmarks.

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Advocates to HHS: Address copay accumulators before new administration enters

by | Nov 19, 2024

The HIV + Hepatitis Policy Institute is urging HHS to require insurers count copay assistance towards patients’ out-of-pocket maximums before President-elect Donald Trump takes office in January, after CMS in its October Notice of Benefit and Payment Parameters (NBPP) proposed rule for 2026 did not address copay accumulators but promised to in future rulemaking.

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While costs have fallen for hepatitis C drugs, Medicaid programs still restrict access

by | Nov 14, 2024

Carl Schmid says that limiting access to direct-acting antivirals “should have never happened” and noted advocacy groups and experts have called for wider access since Solvadi and Harvoni were approved a decade ago. He claims states are breaking federal laws when instituting prior authorization and other restrictions and points to a 2020 study that found class-action lawsuits brought by Medicaid beneficiaries in Colorado, Michigan, Missouri, Washington, and other states “have helped end DAA rationing based on disease severity.”

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