“While this action is certainly welcome, the fact remains that Harvard Pilgrim removed lifesaving HIV drugs from its coverage formulary, disrupted the treatment of people living with HIV, and violated the ACA’s nondiscrimination protections,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “This demonstrates the need for greater oversight of the health insurance industry and enforcement of the safeguards in place to protect patients against the abuse of insurers.”
HIV discrimination complaints filed in five states against insurers for substandard drug coverage & high cost-sharing
“We continue to uncover private insurers that engage in discriminatory plan design by using drug formularies that discourage enrollment of people living with HIV. Putting every HIV drug, including cheap generics, on the highest cost-sharing tier and not covering drugs necessary to treat HIV are blatant examples of discrimination,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Without proper regulation and enforcement, some insurers will try to get away with whatever they can. We call on the state insurance regulators to act quickly on these complaints and immediately ensure these insurers come into compliance.”
After court victories, HIV+Hep calls on state insurance regulators to enforce copay assistance rule
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.
Now that copay assistance must count, government must stop scheme of classifying drugs as “non-essential health benefits”
From the office of Massachusetts Senate President Karen E. Spilka: Senate passes bill expanding access to HIV prevention drug
“For the first time since PrEP became available eleven years ago, over a third of the people CDC believes could benefit from being on PrEP are being prescribed it. However, there are stark and widening racial, ethnic, and gender disparities in PrEP use in Massachusetts and nationwide,” said Kevin Herwig, Health Policy Manager at HIV+Hepatitis Policy Institute. “Allowing pharmacists to prescribe PrEP, as well as to link people with PrEP clinical services and HIV testing, will help remove barriers to getting HIV preventive medication for people and communities who have not yet been able to benefit from the promise of PrEP. We thank the Senate, Senate President Spilka, Senator Cyr, and others for supporting this important legislation.”