Copay accumulators

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Biden-Harris administration urged to comply with court decision & require insurers to count copay assistance

Nov 13, 2024

“In the closing days of this administration they must do the right and very simple thing to help patients afford their prescription drugs—tell insurers that they must comply with the Court decision,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “They have been disregarding the law for over a year, haven’t issued a promised new rule, and time is running out. They need to stop siding with the powerful insurers and their PBMs, and instead side with patients.”

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Biden-Harris administration sides with insurers & fails to take steps to lower patient costs for prescription drugs

Oct 4, 2024

“Every day these rules are delayed is another day that insurers and PBMs are pocketing billions of dollars meant for patients who are struggling to afford their drugs,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Coming from an administration that prides itself on supporting patients and lowering their prescription drug costs, this is a huge disappointment. While they have gone on record that they will issue these rules, the clock is ticking and there isn’t much time left.”

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Senate appropriators maintain funding for domestic HIV & hepatitis programs

Aug 2, 2024

“We sincerely thank Senate Labor HHS Appropriations Subcommittee Chair Tammy Baldwin and Ranking Member Shelley Moore Capito and their colleagues for demonstrating their continued commitment to ending HIV in the United States. While working within the confines of an extremely restrictive budget, they crafted a spending bill that prioritizes the domestic response to HIV,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “However, given that the House version of the bill includes sizeable funding cuts, program eliminations and divisive policy riders, we realize passage of this spending bill is far from reality. House Republicans must come to the table and support bills, such as this one, that can pass the Congress and be signed by the President.”

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Federal Government Refuses to Enforce Copay Assistance Court Victory, But Moves to Stop Scheme of Classifying Drugs as “Non-Essential Health Benefits”

Apr 2, 2024

“This is nonsense: everyone agrees that patients are having trouble affording their prescription drugs, that copay assistance is helping them, and that the plans are pocketing copay assistance without crediting patients, and even though the rule that allowed insurers not to count that assistance has been struck down, our federal government openly refuses to enforce the court ruling,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

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After court victories, HIV+Hep calls on state insurance regulators to enforce copay assistance rule

Mar 13, 2024

Unfortunately, since the court ruling nearly six months ago, we continue to hear from patients complaining that insurers are not counting the copay assistance that they receive, and are being saddled with thousands of dollars in unanticipated out-of-pocket costs for their prescription drugs. Some insurers have told their enrollees that they will not enforce the court ruling without regulator action or a court order.

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