PBMs

Testimony in support of New Jersey A5217 to ban copay accumulators

The HIV+Hepatitis Policy Institute, a leading organization advocating for equitable and affordable healthcare for individuals living with or at risk of HIV, hepatitis, and other chronic health conditions, strongly supports Assembly Bill 5217. This vital legislation ensures that health insurers accept and count payments made on behalf of patients toward their deductibles and out-of-pocket maximums.

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Testimony in support of North Dakota HB1216 to ensure all copays count toward patients’ deductible and out-of-pocket costs

The HIV+Hepatitis Policy Institute, a leading organization advocating for equitable and affordable healthcare for individuals living with or at risk of HIV, hepatitis, and other chronic health conditions, strongly supports House Bill 1216. This vital legislation ensures that health insurers accept and count payments made on behalf of patients toward their deductibles and out-of-pocket maximums.

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Testimony in support of Maryland SB0773 to ban copay accumulators

The HIV+Hepatitis Policy Institute, a leading organization advocating for equitable and affordable healthcare for individuals living with or at risk of HIV, hepatitis, and other chronic health conditions, strongly supports Maryland Senate Bill 773. This vital legislation ensures that health insurers accept and count payments made on behalf of patients toward their deductibles and out-of-pocket maximums.

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Letter to the House Energy and Commerce Health Subcommittee supporting PBM reform

As the Subcommittee examines how reining in pharmacy benefit managers (PBMs) will drive competition and lower costs for patients, we urge Congress to pass meaningful reforms that will ensure patient access to life-saving medications and address the harmful, profit-driven practices of PBMs. For too long, pharmacy benefit managers have profited at the expense of patients living with chronic conditions. These middlemen, who now control 80% of prescription drug claims dictate, with little transparency or oversight, which medications insurers cover, how much patients pay and which administrative hoops patients and providers must jump through to access prescribed treatments.[i] PBMs exploit their dominant market position to extract profits at the expense of patients, particularly those managing chronic conditions such as cancer, diabetes, and HIV. Chronic conditions affect more than 130 million Americans and as of 2022, approximately 1.2 million people were living with HIV nationwide.

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Questions for Mehmet Oz, M.D. for his nomination to lead CMS

As the Committee considers the nomination of Mehmet C. Oz, M.D. to serve as CMS Administrator, the HIV+Hepatitis Policy Institute urges you to ensure the nominee will uphold a stalwart commitment to a comprehensive healthcare system that includes a robust private insurance market, along with strong Medicaid and Medicare programs. All are critical to making American healthier again and in ending the chronic diseases of HIV and hepatitis. Please find attached suggested questions for Dr. Oz concerning 1) a federal court decision regarding copay assistance for prescription drugs, 2) preventive services coverage under the ACA, 3) private insurance prescription drug coverage and affordability policies, and 4) the Medicare Part D six protected classes of prescription drugs.

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