copay accumulator

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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Letter to Mayor Bowser in support of DC’s Copay Accumulator Amendment Act of 2023

HIV+Hep strongly supports the  “Copay Accumulator Amendment Act of 2021” (Bill 25-0141). It simply requires that the copay assistance beneficiaries receive counts towards their out-of-pocket obligation. By signing this law, DC will join 17 other states (Arkansas, Arizona, Connecticut, Delaware, Georgia, Illinois, Kentucky, Louisiana, Maine, Oklahoma, New Mexico, North Carolina, New York, Tennessee, Washington, West Virginia, and Virginia) and Puerto Rico in protecting consumers by assuring their copay assistance will count towards cost-sharing obligations.

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Letter in support of Rhode Island Senate bill on copay assistance

We voice our strong support for Senate Bill 0799 (“Relating to Insurance–Prescription Drug Benefits”) which would require health insurers to accept and count payments made on behalf of patients towards deductibles and out-of-pocket maximums. We thank you for holding a hearing on this important issue and ask that you pass the bill as soon as possible.

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