Insurers

Oral comments before the Federal Trade Commission on PBM Practices

Oral comments before the Federal Trade Commission on PBM Practices

Schemes like refusing to count copay assistance toward patient out-of-pocket costs and designating some medications as “non-essential health benefits” allow PBMs and their insurance partners and others to make more money and profit at the expense of patients who are having trouble affording their drugs. We urge you the Federal Trade Commission to continue your investigation and take appropriate action to stop them.

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Policy updates on accumulators, maximizers, AFPs, and beyond

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.

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Copay accumulator plan designs: What life sciences manufacturers need to know heading into 2024

Copay accumulator plan designs: What life sciences manufacturers need to know heading into 2024

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.

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Federal health policy update

Federal health policy update

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.

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