Cost-sharing

Nation must do better in ensuring patients receive hepatitis C curative drugs

“This situation is completely unacceptable. We have a cure for a serious infectious disease, but people who have taken the time to get tested and know they have hepatitis C are not being cured,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The vast majority of these people have health coverage but payers such as private insurers, state Medicaid programs, and Medicare are erecting barriers to patient access by not covering medications or requiring cumbersome prior authorizations or imposing high patient cost-sharing. If the federal government is serious about ending hepatitis C, it needs to provide the leadership, particularly at CMS, and address these payer barriers.”

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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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U.S. government must quickly act to stop Texas court decision on preventive services and PrEP

While not surprised by Judge O’Connor’s decision, which will immediately impact coverage of HIV testing, hepatitis B and C testing, along with PrEP, it is imperative that these critical preventive services must continue for the health of our nation. We expect that the U.S. government will quickly act to stay this decision so that preventive services can continue nationwide, and appeal it.

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Amicus briefs filed in suit to end policy that prohibits copay assistance from counting toward patients’ out-of-pocket spending

Yesterday, 29 patient, provider, and consumer organizations representing a wide range of illnesses and health conditions filed an amicus brief in support of a case brought against the U.S. Department of Health and Human Services by the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council, the Diabetes Patient Advocacy Coalition, and three patients. Filed in the U.S. District Court for the District of Columbia, the lawsuit challenges the federal 2021 Notice of Benefit and Payment Parameters rule, which allows health insurers to avoid counting the value of drug manufacturer copay assistance toward patients’ out-of-pocket cost obligations. Plaintiffs recently filed a motion for summary judgment, asserting that the rule violates cost-sharing requirements mandated by the Affordable Care Act and is also arbitrary and capricious.

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