ACA

Request for prompt enforcement of prescription drug copay assistance court ruling

We have long advocated for affordable access to healthcare, including prescription medications.  A recent United States District Court for the District of Columbia ruling pertaining to copay assistance will dramatically help patients afford their medications. We write to urge you to immediately enforce this decision and the rule that it reinstated, issue a bulletin advising insurers that they are obligated to comply with the reinstated rule, and take necessary enforcement actions against insurers that are not in compliance.

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Letter in support of Missouri SB 844

It is a pleasure to voice our strong support for Senate Bill 844 (“Requires any amount paid on behalf of a health benefit plan enrollee to count toward the enrollee’s cost-sharing”) which provides that when calculating an enrollee’s overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available. We thank you for holding a hearing on this important issue and ask that you consider and pass the bill.

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Comments on the NBPP proposed rule for 2025

We appreciate all you are doing to make healthcare more accessible and affordable for beneficiaries, including several proposals contained in the proposed rule. While we support several of them, this letter focuses on those issues that impact access and affordability of prescription drugs.

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Comments on 2025 draft letter to issuers in the federally-facilitated exchanges

The HIV+Hepatitis Policy Institute submitted comments recommending that the 2025 Draft Letter to Issuers in the Federal-facilitated Exchange include a reminder to issuers that copay assistance must be counted for all but brand name drugs with a generic equivalent, plans be flagged for adverse tiering when all or a majority of drugs to treat a certain condition are on the highest tiers, CMS takes a more proactive role in enforcement action against insurers that violate the law, and CCIIO fully reviews plans for benefit designs that discriminate against certain individuals.

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