POZ Community Forums

Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: Ptrk3 on April 23, 2019, 06:52:10 am

Title: Centers for Medicare and Medicaid Services Bans Co-pay Accumulators
Post by: Ptrk3 on April 23, 2019, 06:52:10 am
MODERATOR NOTE:  I placed this info as a response in a separate ongoing thread, but the news deserves its own thread because of the potential importance to affected forum members.

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From the April 23, 2019, edition of (online) POZ magazine, this could be a welcome game-changer for affected folks (those on HIV-medication without generic equivalents) as it plays out:

https://www.poz.com/article/centers-medicare-medicaid-services-bans-copay-accumulators

Lede from story and first paragraph:

"People with a chronic illness who need to buy brand-name drugs may be able to save money on their meds thanks to the Centers for Medicare and Medicaid Services (CMS). The federal health agency issued a regulation that bans what are called co-pay accumulators from applying to brand-name drugs for which a generic version is unavailable.

This means that insurers and pharmacy benefit manufacturers (PBMs) can no longer prohibit co-pay assistance provided by drug companies from counting toward a patientís cost-sharing requirements. According to a press release by The AIDS Institute, the ban on co-pay accumulators was included in the Health and Human Services Departmentís 2020 Annual Notice of Benefit and Payment Parameters."

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