WASHINGTON, D.C.- December 16, 2022 – In response to draft rulemaking for the Centers for Medicare & Medicaid Services’ (CMS) Notice of Benefit and Payment Parameters (NBPP) for 2024, the All Copays Count Coalition, which comprises more than 80 groups representing patients with serious and chronic health conditions, today released the following statement:
“We urge CMS to address the use of copay accumulator adjustment policies in its final Notice of Benefits and Payment Parameters. These practices have disproportionate impacts on individuals with serious and chronic health conditions, causing undue burden for accessing critical and lifesaving medications. It is increasingly frustrating that these challenges are well known and documented and there remains no resolution.
“The All Copays Count Coalition continues to champion policies that remove barriers to medications for patients and looks forward to advancing its partnerships with stakeholder groups, federal agencies and lawmakers on commonsense solutions that expand and protect access to lifesaving care. Congress must pass the HELP Copays Act, which would provide a federal solution to protect all patients from the harmful impact of copay accumulator adjustment policies.”
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About the Issue
Millions of patients who depend on financial assistance to afford their medications are being told that the money must come out of their own pocket before they can get their medications. Health plan policies called copay accumulator adjustments no longer count financial assistance toward the patient’s annual deductibles or their out-of-pocket maximum. First the patient’s copay assistance covers out-of-pocket costs at the pharmacy; and then, when the assistance runs out, the patient must pay what the manufacturer assistance already covered for their deductible or out-of-pocket maximum. Patients only use copay assistance for medications they’ve been prescribed after less expensive options did not work, and they have no alternative. Most drugs that offer copay assistance are brand drugs that do not have a generic alternative. Copay accumulator adjustor policies hurt patient access to medicines, decrease drug adherence, and even cost our health care system more money.
About the All Copays Count Coalition:
The All Copays Count Coalition (ACCC) includes The AIDS Institute, the Arthritis Foundation, the Cancer Support Community, the Immune Deficiency Foundation, the National Hemophilia Foundation, the National Multiple Sclerosis Society, and more than 80 other groups serving the interests of patients with chronic and serious health conditions that rely on copay assistance in various forms to make medically necessary drug treatments affordable. Learn more at www.AllCopaysCount.org or connect with us on Facebook, Twitter and LinkedIn.