Letters

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New Hampshire letter on substandard & discriminatory HIV medication coverage & plan design by Harvard Pilgrim Health Care

Nov 8, 2024

The HIV+Hepatitis Policy Institute is writing to express our concern about substandard, discriminatory coverage of HIV treatment medications by Harvard Pilgrim Health Care health plans that use its 2025 “Core 4 Tier” and “Core 5 Tier” formularies in New Hampshire. These plans do not meet the regulatory standards for formulary adequacy in CFR 156.122 (a)(3)(iii)(H) by failing to cover treatment regimens recommended in broadly accepted treatment guidelines and that are indicative of clinical best practice, thereby discouraging enrollment by people living with HIV.

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Maine letter on substandard & discriminatory HIV medication coverage & plan design by Harvard Pilgrim Health Care

Nov 8, 2024

We, the undersigned organizations and individuals, are writing to express our concern about substandard, discriminatory coverage of HIV treatment medications by Harvard Pilgrim Health Care health plans that use its 2025 “Core 5 Tier” formulary in Maine. These plans do not meet the regulatory standards for formulary adequacy in CFR 156.122 (a)(3)(iii)(H) by failing to cover treatment regimens recommended in broadly accepted treatment guidelines and that are indicative of clinical best practice, thereby discouraging enrollment by people living with HIV.[1] 

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Substandard and discriminatory HIV medication coverage and plan design by Community Health Choice Texas

Oct 7, 2024

We are writing to express our continuing concern about substandard, discriminatory coverage of HIV treatment medications on Community Health Choice Texas “Premier” and “Select” health insurance plans.  As we have previously stated, the formularies for these plans, among other things, do not meet the regulatory standards for formulary adequacy in CFR 156.122 (a)(3)(iii)(H) by failing to cover treatment regimens specified in broadly accepted treatment guidelines and that are indicative of clinical best practice, and by discouraging enrollment by people living with HIV.

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63 HIV organizations request for updated USPSTF PrEP guidance & issuer compliance

Jul 17, 2024

We, the undersigned 62 organizations dedicated to the fight to end HIV, write to request CMS issue updated guidance in order to ensure issuer compliance with the most recent, updated United States Preventive Services Task Force (USPSTF) recommendation for HIV Pre-Exposure Prophylaxis (PrEP). As community-based organizations, advocacy groups, clinical providers, and public health practitioners working with people and communities affected by HIV, we know the urgency of ensuring broad and equitable access to PrEP free of insurance barriers.

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Concerns with Rhode Island Drug Cost Review Commission (S 2719)

May 14, 2024

Given the important nature of prescription drugs to the life-saving treatment of HIV and hepatitis B, and now the cure of hepatitis C and the prevention of HIV, we have long advocated for affordable access to prescription medications. We applaud your commitment to ensuring that beneficiaries can access and afford the prescription medications that their providers prescribe. While we support and share the committee’s intent to lower out-of-pocket costs for consumers, we believe the proposed Rhode Island Drug Cost Review Commission (S 2719) would neither benefit patients in the long run nor result in reducing patients’ costs.

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