Carl Schmid presented at the NAIC Spring Meeting on how PBMs impact patient drug costs and access to drugs by placing drugs on high-cost tiers and not counting copay assistance toward patient out-of-pocket costs. He reviews state and federal actions to stop these harmful practices.
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 discusses NC Blue Cross Blue Shield’s decision to remove HIV drugs from the highest and costliest drug tiers following a discrimination complaint filed by the HIV+Hepatitis Policy Institute and NC AIDS Action Network.
At the NAIC meeting, Carl Schmid and colleagues present consumer representatives’ report on investigation of how insurers are implementing ACA preventive service requirements, including PrEP, and urge state regulators to take action to ensure insurers are compliant with the law.
NAIC Consumer Reps. Carl Schmid and Deb Darcy discuss barriers consumers face in accessing healthcare through the high number of prior authorizations and the appeals and denials process, and request the NAIC develop a workstream that improves data collection, and consumer awareness of the appeals process, update model laws, and better enforcement of federal and state laws and regulations.