HIV+Hep in the News

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What will payers do if courts strike down the ACA’s no-cost requirement for preventive services?

by | Sep 7, 2022

“This disproportionately impacts Black and Latino people,” comments Carl Schmid, executive director of the HIV + Hepatitis Policy Institute, who also noted the importance of the ACA’s no-cost coverage of tests for hepatitis and sexually transmitted infections. “If first-dollar coverage went away, people won’t pick up the drug. That would be extremely damaging for our efforts to end HIV and hepatitis.”

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Court: Employer provided insurance can exclude coverage of PrEP

by | Sep 7, 2022

A U.S. District Court on Wednesday ruled against a federal mandate requiring employer provided health plans to cover PrEP (Pre-exposure prophylaxis), a drug used for the prevention of HIV. The mandate, a provision of the Affordable Care Act (ACA), violates tenets of the federal Religious Freedom Restoration Act, according to Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas.

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Federal judge rules against Obamacare coverage of HIV prevention drugs

by | Sep 7, 2022

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, told Roll Call that he expects the case will be appealed. “Preventive services covered by private insurance plans without cost-sharing, such as HIV testing, hepatitis B and C testing, and PrEP, are all critical and well-established public health preventive services that must continue,” he said in a statement. “To single out PrEP, which are FDA approved drugs that effectively prevent HIV, and conclude that its coverage violates the religious freedom of certain individuals, is plain wrong.”

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HIV, diabetes groups challenge HHS over no-copay rule

by | Sep 1, 2022

For years, pharma industry allies have sought to put the brakes on a payer tactic that blocks copay discounts from counting toward patients’ deductibles and out-of-pocket maximums. Three advocacy groups, representing HIV and diabetes patients, are hoping they’ve found a way to end the programs nationally. The HIV+Hepatitis Policy Institute, the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition filed suit in U.S. District Court this week to challenge a federal rule codifying the tactic, known as copay accumulator adjustment.

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