Copay Accumulators Get A Reprieve: Commercial Plans’ Use Will Not Be Restricted By CMS – Yet
US Health and Human Service Department questions recent federal court decision striking down the government’s policy of allowing plans to broadly exclude manufacturer copay assistance from counting toward patient deductibles or out-of-pocket maximums.
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‘Essential Benefit’ Drug Coverage Protections Is Next Priority For Patient Group Behind Copay Accumulator Victory
HIV+Hepatitis Policy Institute provides CMS with a long list of plan sponsors and vendors that appear to be engaged in the practice, which the group argues circumvents the cost sharing protections provided by the Affordable Care Act for hundreds of drugs.
Copay Maximizers May Be Restricted In Small Private Plans Under CMS Proposal: Will Broader Impact Follow?
The Centers for Medicare and Medicaid Services requests stakeholder feedback on how extensively copay maximizers are being used by insurers, which could help pave the way for restrictions on large employer and self-insured plans.
Programs only allowed for brands with generic competition under court ruling, but related programs such as copay maximizers and so-called ‘alternative funding’ programs are not directly impacted by the decision.