As Congress considers reforms to private health insurance, we urge you to ensure that coverage provides meaningful access to the medications, services, and care patients need and protects them from practices that shift costs or create unnecessary barriers to treatment.
We are writing to urge you to require Blue Cross Blue Shield Federal Employee Plan (FEP), the largest carrier in the Federal Employees Health Benefits (FEHB) Program, to fully cover long-acting injectable PrEP products. We are most concerned that BCBS is charging cost-sharing for Yeztugo (lenacapavir), violating OPM’s requirement that carriers cover all FDA-approved PrEP drugs without cost-sharing.
We submitted comments to Pharmacy Quality Alliance supporting a timely replacement of the ARV treatment adherence measure and urging a new PrEP adherence measure, with both measures designed to account for #insurer-imposed disruptions in HIV care.
We support the adoption of stronger quality measures for HIV and viral hepatitis, including screening and treatment for hepatitis B and C, as well as a more accurate ADAP 340B calculation for the Medicare drug inflation rebate. Federal & state quality measures help ensure that health systems prioritize these key interventions.
We strongly believe that access to all forms of PrEP is essential to ending HIV in California. Nearly 5,000 Californians are diagnosed with HIV each year, and persistent disparities underscore the need to ensure access to the full range of HIV prevention options. Patients should be able to choose the PrEP option that works best for them without unnecessary insurance or administrative barriers. For these reasons, we respectfully urge you to sign Senate Bill 1023 into law.