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.

Improving access to preventive services consumer protections
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.

Claims chaos: barriers to health insurance: Prior authorization, denials & appeals
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.

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.

Role of PBMs in patient access & affordability of prescription drugs & potential solutions
HIV+Hep’s Carl Schmid, a consumer representative to the National Association of Insurance Commissioners (NAIC), presents to the NAIC PBM subgroup, along with ACSCAN’s Anna Howard, on how PBM’s impact patient access and affordability of prescription drugs.