HIV+Hep in the News

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CMS rejects call to ban copay accumulators in draft 2024 exchange rule

by | Dec 13, 2022

Carl Schmid, executive director of the HIV+HEP Policy Institute, is hopeful that ongoing legal action the institute and two other organizations took against the government on the issue may lead to the change the group is pushing for, as he said patient advocates have seen “no action by the federal government on this issue.”

Copay coupons are currently banned by Medicare but allowed in the commercial market, including for Affordable Care Act plans. The final 2021 NBPP rule allowed enforcement of copay accumulator programs, and the agency has continued to permit the policy since then, despite long-standing objections from patient groups.

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Long-Acting injectable PrEP as HIV prevention scores an A grade

by | Dec 13, 2022

“We are extremely pleased that the USPSTF, at our request, has updated its recommendation for PrEP to prevent HIV and include newly approved long-acting drugs,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in statement. “Due to the importance of preventing HIV and the superiority of long-acting PrEP compared to daily oral PrEP, the USPSTF acted in record speed. Now we urge insurers to ensure its coverage and offer it without cost-sharing.”

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HIV advocates lodge discrimination complaints across NC insurer

by | Dec 12, 2022

Two HIV/AIDS patient advocacy organizations have filed discrimination complaints against North Carolina Blue Cross Blue Shield, alleging that its drug formulary discriminates against patients with HIV because almost all drugs to treat and prevent the condition are placed on its highest cost-sharing tier. The HIV+Hepatitis Policy Institute (HPI) and the North Carolina AIDS Action Network announced Thursday (Dec. 8) that they were filing complaints with the North Carolina Department of Insurance and the Office of Civil Rights at HHS, alleging that the insurer is requiring HIV patients, or those aiming to prevent HIV infection, to pay unfairly high costs.

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BCBS North Carolina accused of discriminatory drug pricing by HIV advocacy groups

by | Dec 12, 2022

Two HIV advocacy groups allege Blue Cross Blue Shield of North Carolina is violating antidiscrimination requirements by pricing HIV drugs in high cost-sharing tiers. The HIV+Hepatitis Policy Institute and the North Carolina AIDS Action Network filed complaints with the HHS civil rights department and the North Carolina insurance department Dec. 8. In the complaints, the organizations claim BCBS North Carolina places most drugs for HIV treatment, including generics, in higher formulary tiers, which mean higher cost-sharing rates for patients.

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Blue Cross and Blue Shield accused of discrimination by HIV advocates

by | Dec 11, 2022

Two separate complaints have been filed against the North Carolina Blue Cross and Blue Shield claiming discrimination against HIV patients. The suits, filed by the HIV+Hepatitis Policy Institute and the North Carolina AIDS Action Network, claim the insurance company places almost all HIV drugs, including generic PrEP, on the highest drug tier. This effectively causes those living with and vulnerable to HIV to pay the excessively high costs for their drugs.

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