Copay accumulators

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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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Testimony on the IL Health Care Availability and Access Board Act (HB 4472)

Mar 12, 2024

We believe policymakers should focus on those issues that directly impact patients, such as PBM regulation and reform, standard plan designs with reasonable deductibles and nominal copays, and ensuring copay assistance counts. We realize that Illinois has taken many of these steps already, and that Illinois policymakers are advocating for change at the national level, too, but more can be done.

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Comments in support of New Hampshire SB 354

Jan 23, 2024

It is a pleasure to voice 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. We thank you for holding a hearing on this important issue and ask that you consider and pass the bill.

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Letter in support of ensuring copay assistance counts & reining in unscrupulous prescription drug practices

Apr 28, 2023

We strongly support your bipartisan leadership in taking action to address some of the abusive practices Pharmacy Benefit Managers (PBMs) engage in that hinder patient access and the affordability of prescription drugs. While most people think insurers make the majority of decisions regarding health coverage and affordability, when it comes to prescription drugs, it is PBMs that drive many of the decisions as to what medications a beneficiary can access and how much they pay for them.

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