“While we were predicting the worst, at the moment, insurers will still have to cover preventive services, including PrEP, except for the original plaintiffs. That is the good news,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in a statement. “The bad news is, the court still finds the mandate to cover USPSTF recommended services unconstitutional and now asks the lower court to review both the [Health Resources and Services Administration] and [Advisory Committee on Immunization Practices] preventive services,” Schmid continued. “The case is not going to the Supreme Court at this time but back to the lower court. Coverage of preventive services continues.”
Senate maintains HIV funding
“While disappointed that Congress will not be providing the necessary funding to really end HIV or hepatitis in the United States, given the severe budget constraints, what the Senate has proposed will allow existing programs to at least continue,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in a statement. “Now, for the benefit of the country, it is up to the House to act in a responsible manner and fund the federal government at the necessary levels in a timely fashion.”
An upcoming White House decision may jeopardize Americans’ access to life-saving drugs
Copay assistance is critical for many patients—including those with cancer, arthritis, hemophilia, multiple sclerosis, HIV and hepatitis—to afford their high copays, pointed out Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Once the copay assistance runs out, the patient goes to pick up their drug and they are slapped with a several thousand dollar bill. This is a surprise to them—they thought they were picking up their drug with no problem, but they later learned that the copay assistance the insurer was collecting was not counting and in order to pick up their drug, they need to come up with that money,” he explained.
Senate Approps asks for more hepatitis work without pay raise
The CDC’s hepatitis division funding would stay at $43 million in the Senate bill and the CDC Opioid Related Infectious Disease program (ORIDP) would remain at $23 million. According to the HIV+Hepatitis Institute, the House bill also adds an additional $6 million for the ORIDP. “It’s a shame that the Senate did not increase the funding because they gave them more work to do,” Carl Schmid, director of the Institute, told Inside Health Policy.
Senate appropriators ask for copay accumulator enforcement brief
Carl Schmid told Inside Health Policy that with congressional eyes on CMS’ enforcement, pressure is building for the agency to enforce the 2020 rule. “It shows CMS that Congress is looking into this and concerned about this issue,” Schmid said. “The court decided this last December, and now it’s August, and we still don’t know CMS’ next steps on this.”