HIV+Hep in the News

A collection of patient advocacy groups is suing to demand the federal government outlaw copay accumulator programs they say inflate healthcare costs. The three groups filed the lawsuit Tuesday in the U.S. District Court for the District of Columbia challenging the legality of a Trump-era rule that allows insurers to avoid counting the value of drugmaker coupons toward patient out-of-pocket costs and deductibles. These policies, referred to as copay accumulator adjustment programs, significantly increase patients’ costs, the groups claim.

Three patient advocacy groups are suing the U.S. government to challenge the legality of a federal rule that allows health insurers to not apply drugmakers’ copay assistance toward patients’ out-of-pocket cost obligations.

In a lawsuit filed Tuesday in the U.S. District Court for the District of Columbia, the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition argue that the rule disproportionately impacts people with chronic diseases, like diabetes and HIV, that require the use of costly drugs. The groups filed the suit against the Department of Health and Human Services and the Centers for Medicare and Medicaid Services.

Three patient groups are suing HHS over a rule that lets exchange plans exclude copay assistance from patients’ out-of-pocket cost obligations for prescription drugs. The rule contradicts the Affordable Care Act’s definition of cost sharing, according to a lawsuit filed in the U.S. District Court for the District of Columbia Tuesday (Aug. 30) . Medicare prohibits copay coupons, but drug companies may help people with exchange plans afford drug copays.

Three patient groups sued HHS Tuesday over a Trump-era rule that lets health insurers ignore the value of drug manufacturer copay assistance when calculating whether patients have met their out-of-pocket maximums. The groups — the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition — argue that the rule, in the Notice of Benefit and Payment Parameters for 2021, runs afoul of annual Affordable Care Act cost-sharing requirements. The organizations represent patients with chronic illnesses who often need expensive specialty drugs to manage their diseases.