The Biden administration released a proposed rule that will govern how private health plans must operate in 2023 and in doing so, took some steps to limit patient cost-sharing for prescription drugs. However, despite the urging from patient groups, they are not requiring insurers and pharmacy benefit managers (PBMs) to count copay assistance towards patient out-of-pocket cost-sharing and deductibles.
Bipartisan bill makes drugs more affordable by ensuring copay assistance counts
The “Help Ensure Lower Patient Copays Act” would ban a cruel practice implemented by insurance companies that accept a patient’s copay assistance but does not apply it to the patient’s deductible and out-of-pocket cost obligations. This leaves the patient with potentially thousands of dollars in unanticipated costs.
Biden administration passes on protecting patient affordability of medications
“We are deeply disappointed that CMS passed on addressing the issue of copay assistance for prescription drugs and requiring insurers and pharmacy benefit managers (PBMs) to count assistance towards patient out-of-pocket cost-sharing and deductibles,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.
Trump Administration fails to protect patient affordability of medications: Biden Administration must step in to improve affordability
Washington DC… Today, the Trump administration rushed out the partial release of the rules that govern how private health plans must operate in 2022 and in doing so…
Trump Administration temporarily backs off from proposal that would endanger patient copay assistance
Washington DC… In a victory for patients’ ability to afford prescription drugs, the Trump administration has delayed for two years implementation of a provision included in a proposed…