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.
With Court victories, patient groups drop appeal in copay assistance case
“Now that the court has struck down the rule that allowed insurers and PBMs not to count copay assistance and clarified that the previous rule—requiring copay assistance to count in most instances—is now in effect, we now must turn to enforcement to ensure patients are no longer being financially harmed by copay accumulators,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, one of the plaintiffs in the lawsuit. “We are already hearing from patients that insurers are still subjecting them to these unscrupulous and now, illegal practices, and we will ensure that any unlawful practices stop.”
Government drops appeal in copay assistance case
“We are pleased that the government has withdrawn its appeal of our court victory for patients who struggle to afford their prescription drugs and rely on copay assistance,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, one of the plaintiffs in the lawsuit. “Now, insurers must heed the court ruling by ending their cruel policy of collecting copay assistance and not applying it to patients’ cost-sharing obligations.”
Now that copay assistance must count, government must stop scheme of classifying drugs as “non-essential health benefits”
Victory for patients reiterated–Court makes it clear: Rule requiring copay assistance to count now in effect
“We thank the Court for siding, yet again, with patients who struggle to afford their prescription drugs and rely on copay assistance,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, one of the plaintiffs in the lawsuit. “The Court has clarified what we have been asserting: the rule that states copay assistance must count is in effect. Now, that clear rule must be followed by insurers.”