Speaking at InformaConnect’s #Copay2024, Kevin Herwig gave a policy update on developments related to copay accumulators, maximizers, and alternative funding programs and the failure of HHS to enforce the HIV+Hepatitis Policy Institute’s Court victory a year ago or fully close the loophole allowing insurers to designate prescription drugs as non-essential health benefits.
Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, and Bill Sarraille, a partner with Sidley law, speak with Michael Harris, Mercalis’s VP of Patient Support Services Strategy, on the litigation brought by the HIV+Hepatitis Policy Institute against a federal government rule allowing insurers to not count copay assistance toward patient costs. The Court ruled in favor of patients but the government appealed and is refusing to enforce the Court’s ruling.
Carl Schmid provides an update to the NAIC on copay accumulator litigation, including the government’s recent move to appeal and seek clarification from the court and the need for state and federal enforcement that copay assistance, in most instances, must count.
Carl Schmid, along with fellow NAIC Consumer Reps, provide an update to Insurance Commissioners on federal issues including proposed changes to standard plans, , reminders to issuers against using discriminatory plan design, and an update on transparency in coverage requirements and Congressional consideration of PBM regulation.
Carl Schmid discusses how the district court decision that HHS must require insurers to count copay assistance towards patient out-of-pocket costs helps to make prescription drugs more affordable and accessible for patients.