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.
Plan benefit design, prescription drugs, and race
Carl Schmid presents to NAIC Special Committee on Race & Insurance on how insurance benefit design impacts prescription drug access for racial and ethnic communities and suggestions for overcoming access barriers by reducing utilization management measures, lowering cost-sharing, offering standardized plans, and enforcing ACA non-discrimination policies.
Importance of copay assistance in patient affordability of prescription drugs
Copay assistance provides a safety net to help patients afford and adhere to medically-necessary medications. But, the Centers for Medicare & Medicaid Services (CMS) Best Price Rule, finalized by the Trump administration in 2020, threatens patient access to these critical programs. If implemented, the final rule would allow insurers and pharmacy benefit managers (PBMs) to undermine copay assistance through copay accumulator adjustment programs that block patient assistance from counting towards a patient’s deductible and out-of-pocket cost-sharing requirements. Watch this virtual briefing to learn about the value of patient copay assistance programs and how you can get engaged to protect communities from the unintended consequences of the CMS Best Price Rule.
Patient messaging for prescription access and affordability Issues: Communicating with legislators
A discussion on Chronic Care Policy Alliance’s priorities and tips on how to reach out to elected officials.
Role of state regulators in addressing discriminatory benefit design
Carl Schmid presents at National Association of Insurance Commissioners, along with other consumer representatives, on discrimination in insurance benefit design with a focus on prescription drugs and adverse tiering.