ACA

Insurer responds to HIV discrimination complaint by lowering patient costs for drugs

Months after the HIV+Hepatitis Policy Institute and the North Carolina AIDS Action Network filed discrimination complaints against Blue Cross and Blue Shield of North Carolina for placing almost all HIV drugs on the highest drug tiers, the insurer has released a new mid-year drug formulary that leaves not a single HIV drug on the highest and most costly drug tiers. Instead of 48 HIV drugs, including many generics, on Tiers 5 and 6, there are now none.  As a result, depending on the plan, patients will be paying more reasonable and affordable costs.

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USPSTF updates PrEP recommendation to include long-acting PrEP to prevent HIV

“The ACA recognized the value of preventive services to individual health, public health, and reducing healthcare costs. They also help identify conditions early on when more can be done to treat them or prevent disease acquisition altogether. Insurers are simply not doing a good job of making it easy for consumers to utilize them and regulators must take action to ensure access to these mandated life-saving services,” said Carl Schmid, Executive Director of the HIV+Hepatitis Policy Institute and a Consumer Representative to the NAIC.

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Consumer Representatives to the NAIC call for regulators to shore up ACA preventive services protections

“The ACA recognized the value of preventive services to individual health, public health, and reducing healthcare costs. They also help identify conditions early on when more can be done to treat them or prevent disease acquisition altogether. Insurers are simply not doing a good job of making it easy for consumers to utilize them and regulators must take action to ensure access to these mandated life-saving services,” said Carl Schmid, Executive Director of the HIV+Hepatitis Policy Institute and a Consumer Representative to the NAIC.

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25 HIV and Hepatitis organizations file amicus brief to protect preventive services coverage

The HIV+Hepatitis Policy Institute and 24 other HIV and hepatitis organizations filed an amicus brief in support of the U.S. government in Braidwood Management v. Becerra, the challenge to the ACA’s preventive services coverage requirement, arguing, “A wholesale invalidation of the coverage requirement for USPSTF’s recommendations would strike a critical, unnecessary, and costly blow to the battle to end HIV, hepatitis, and other infectious diseases.”

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Patient groups reply to government’s brief in landmark lawsuit challenging copay accumulators

The HIV+Hepatitis Policy Institute, Diabetes Leadership Council, Diabetes Patient Advocacy Coalition, and three patients filed their reply in support of their motion for summary judgment in the U.S. District Court for the District of Columbia in their ongoing lawsuit against copay accumulators. The suit challenges HHS’s 2021 Notice of Benefit and Payment Parameters rule, which permits insurance plans to refuse to credit copay assistance from drug manufacturers toward beneficiaries’ deductibles and out-of-pocket maximums.

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