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.


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:


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."