Preventive services covered by private insurance plans without cost- sharing, such as HIV testing, hepatitis B and C testing, and PrEP, are all critical and well-established public health preventive services that must continue. To single out PrEP, which are FDA approved drugs that effectively prevent HIV, and conclude that its coverage violates the religious freedom of certain individuals, is plain wrong, highly discriminatory, and impedes the public health of our nation. PrEP is not just for gay men, but for anyone who may be at risk of HIV.
Patient groups file suit to end policy that prohibits copay assistance from counting toward patients’ out-of-pocket spending
The HIV+Hepatitis Policy Insite, the Diabetes Leadership Council, and the Diabetes Patient Advocacy Coalition filed suit in the U.S. District Court for the District of Columbia challenging a federal rule that allows health insurers and pharmacy benefits managers to avoid counting drug manufacturer copay assistance toward patients’ out-of-pocket cost obligations. Due to increased deductibles and cost-sharing requirements, patients rely on copay assistance to help them afford their #Rx.
CDC data shows only one-third of people diagnosed with hepatitis C access treatment
Today, the Centers for Disease Control and Prevention (CDC) released disturbing data that shows that only one-third of people diagnosed with hepatitis C who have healthcare coverage are being treated with curative medications within one year of diagnosis. “Despite having health coverage and cost-effective drugs that can cure hepatitis C in as little as 8-12 weeks, our healthcare system is failing to provide the treatment people with hepatitis C need and is required to end this potentially deadly infectious disease,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.
Senate Appropriations leadership proposes significant increases for domestic HIV programs
The leadership of the United States Senate Appropriations Committee is proposing to significantly increase funding to continue to ramp up efforts to end HIV in the United States. The Senate bills include increased funding for the Ending the HIV Epidemic in the U.S. initiative by at least $240 million for domestic HIV testing, prevention, treatment, and research programs. While it is not as much as proposed in President Biden’s budget, in some instances it is more than what was proposed by the House.
Insurers warned that excessive utilization management of prescription drugs is potentially discriminatory
As part of the Biden administration’s proposed rule to implement the Affordable Care Act’s nondiscrimination provisions, excessive use of utilization management for prescription drugs, including prior authorization, step therapy, and durational or quantity limits could be deemed discriminatory. Additionally, the proposed rule adds back protections that prohibit insurers and other health programs from engaging in marketing practices and benefit design that discriminate on the basis of certain conditions, including disability.