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.
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.
Letter in support of ensuring copay assistance counts & reining in unscrupulous prescription drug practices
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.
We strongly support SB 184, Prescription Cost Amendments, 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 consider and pass the bill.
50 patient groups comment in response to the request for information on essential health benefits [CMS-9898-NC]
We believe that the EHB regulations governing prescription drugs have generally been working well for patients; however, we propose some areas for improvement and are very concerned that there has been a lack of enforcement of the EHB regulations, an erosion of essential health benefits over the years, and some insurers and pharmacy benefit managers (PBMs) are devising ways to skirt the intent of the EHB law and regulations.