The HIV+Hepatitis Policy Institute (HIV+Hep) and American Autoimmune Related Diseases Association (AARDA), along with 38 other patient organizations, filed comments earlier this week with the U.S. Department of Health and Human Services (HHS) addressed to Secretary Xavier Becerra that urge HHS to improve the affordability of prescription drugs for patients in the private insurance market through Standard Benefit Plans.
Today, the federal government issued guidance to insurers to remind them of their obligation to cover pre-exposure prophylaxis (PrEP), which are drugs that prevent HIV, at no cost to their beneficiaries. The guidance, in the form of an FAQ, also clarifies that associated services with PrEP, such as provider visits and HIV, hepatitis, and STD testing along with other laboratory tests, must also be covered with no patient cost-sharing. This follows previous guidance for the coverage of other preventive services that have associated services and costs, such as colonoscopies.
“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.
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