PBMs

Tackling copay accumulator and maximizers

Tackling copay accumulator and maximizers

Carl Schmid participates in the “Prescription for Better Access” podcast with Lauren Crawford Shaver and hosts Mark Hansan and Dr. Scott Howell to examine how PBM copay accumulator and maximizer policies harm patients by not counting copay assistance toward patient out-of-pocket costs and deductibles, and what can be done to keep prescription drugs accessible and affordable.

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Discrimination in prescription drug formularies

Discrimination in prescription drug formularies

Carl Schmid discusses discrimination in prescription drug formularies, demonstrating how some PBMs and private insurers violate ACA provisions and hurt patients by placing life-saving prescription drugs on higher cost tiers.

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Ensuring copay assistance counts for patients: Litigation update

Ensuring copay assistance counts for patients: Litigation update

At Informa Connect’s Copay, Reimbursement and Access Congress, Carl Schmid discusses the litigation filed by HIV+Hep, the DLC, and the DPAC in the U.S. District Court for DC challenging a federal rule that allows health insurers to avoid counting the value of drug manufacturer copay assistance toward patients’ out-of-pocket cost obligations in violation of the ACA definition of and regulations for cost-sharing.

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Ensuring copay assistance counts for patients: A federal update

Ensuring copay assistance counts for patients: A federal update

Carl Schmid discusses on a National Consumers League webinar current federal advocacy efforts to ensure that copay assistance for prescription drugs counts. This includes comments on two regulations, a congressional bill, and recent litigation initiated by HIV+Hep and two diabetes groups.

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Press briefing on HIV+Hep, DLC, and DPAC vs. HHS

The HIV+Hepatitis Policy Insite, the Diabetes Leadership Council, and the Diabetes Patient Advocacy Coalition filed suit in the U.S. District Court for the District of Columbia challenging a federal rule that allows health insurers and pharmacy benefits managers to avoid counting drug manufacturer copay assistance toward patients’ out-of-pocket cost obligations. Due to increased deductibles and cost-sharing requirements, patients rely on copay assistance to help them afford their medications.

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