Copay accumulators

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Support for Oregon enhancing transparency around the use of copay accumulators, copay maximizers, and alternative funding programs

Oct 11, 2024

As the Oregon legislature considers modifications to SB 844, we write to express our support for proposed legislative recommendations including enhancing transparency around the use of copay accumulators, copay maximizers, and alternative funding programs. In recent years, insurers and their PBMs have implemented harmful policies that shift financial responsibilities for prescription costs to patients by not applying copayment assistance from drug manufacturers and sometimes charitable organizations.

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Illinois testimony on PBM treatment of specialty drugs

Sep 11, 2024

I would like to highlight the direct impact of PBM actions on patients, specifically on whether they can access the drug that their provider prescribes and the cost they will pay. Much of this is carried out behind the scenes and without regulation. However, that is beginning to change with more states passing bipartisan legislation to regulate PBMs and even the very partisan Congress is working on federal legislation that will hopefully pass this year.

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Support for NH SB 354 relative to insurance cost-sharing calculations

Apr 29, 2024

It is a pleasure to reiterate our strong support for Senate Bill 354-FN (“relative to insurance cost-sharing calculations”) which would require health insurers and pharmacy benefit managers to include any amount paid by the enrollee or on their behalf in calculating an enrollee’s contribution to cost-sharing requirements. Now that the Senate successfully passed the bill, we are pleased that you will be holding a hearing on this important issue and that you too will pass the bill.

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Support for Rhode Island’s H 8041 “An Act Relating to Insurance—Prescription Drug Benefits”

Apr 4, 2024

We voice our strong support for Rhode Island’s H 8041 (“An Act Relating to Insurance—Prescription Drug Benefits”) which stipulates that, when calculating an enrollee’s overall contribution to any out-of-pocket maximum or any cost-sharing requirement under a health plan, an insurer or pharmacy benefit manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee by another person. We thank you for considering this legislation and are pleased to offer our support.

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Support for CA AB 2180 “Health Care Coverage: Cost Sharing”

Mar 25, 2024

HIV+Hep strongly supports AB 2180. It simply requires that the copay assistance which beneficiaries receive counts towards their out-of-pocket obligations. By passing this law, California will join 19 other states (Arkansas, Arizona, Colorado, Connecticut, Delaware, Georgia, Illinois, Kentucky, Louisiana, Maine, Oklahoma, North Carolina, New Mexico, New York, Tennessee, Texas, Washington, West Virginia, and Virginia), Puerto Rico and the District of Columbia in protecting consumers by assuring their copay assistance will count towards cost-sharing obligations.

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