“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.
Biden budget maintains domestic HIV funding & proposes PrEP & hepatitis C programs
“While we appreciate the proposed continued funding of domestic HIV and hepatitis programs and acknowledge the legislatively imposed budget constraints and competing priorities, the reality is that, without serious increases, our nation cannot meet its goals to end the HIV and hepatitis epidemics on time,” commented Carl Schmid, Executive Director of the HIV+Hepatitis Policy Institute. “Now, we must take our case for any funding increases to Congress, which has found it difficult to agree on spending bills, and House Republicans have even proposed to cut domestic HIV spending this year by $767 million.”