While we would have liked to see improved outcomes, federal funding for CDC HIV prevention and the Ryan White HIV/AIDS care and treatment program, along with other critical programs, has remained flat for years. The only increases have been for the Ending the HIV Epidemic initiative, and even that program hasn’t received the increases it needs to be successful,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Without significant increases for care and treatment, and prevention programs, including those for PrEP, sadly we will continue to experience only small drops in the number of new diagnoses, and racial and ethnic disparities will persist. As a nation, we can and must do better.”
Biden administration strengthens patient protections in accessing prescription drugs
“We applaud the Biden administration’s strengthening of the nondiscrimination regulation in order to ensure that patients, particularly those who rely on prescription drugs, are better protected against the discriminatory practices of some insurers and PBMs,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Patients are being faced with high cost-sharing, excessive utilization management techniques, such as prior authorization, drug exclusions, and now even AI tools that decide what drugs they can receive. We can now be assured that, thanks to the ACA, they must be implemented in a nondiscriminatory manner.”
Federal Government Refuses to Enforce Copay Assistance Court Victory, But Moves to Stop Scheme of Classifying Drugs as “Non-Essential Health Benefits”
“This is nonsense: everyone agrees that patients are having trouble affording their prescription drugs, that copay assistance is helping them, and that the plans are pocketing copay assistance without crediting patients, and even though the rule that allowed insurers not to count that assistance has been struck down, our federal government openly refuses to enforce the court ruling,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.
Congress agrees to maintain funding for domestic HIV programs
“After House Republicans initially put at risk the nation’s progress in ending HIV, we are relieved that House and Senate congressional negotiators have agreed to maintain funding for domestic HIV prevention, care, and treatment programs,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.
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.