AIDS Institute Issues Statement on Drug Copay Assistance Policy

WASHINGTON, Aug. 26 -- AIDS Institute issued the following statement:

After stating in the 2020 Notice of Benefit and Payment Parameters rule that copay assistance from drug companies must count towards a patient's deductible and out-of-pocket maximum in most cases, today the Center for Consumer Information and Insurance Oversight (CCIIO) released a FAQ stating they will temporarily not require plans and states to enforce the provision and will revise the policy in the upcoming 2021 Notice of Benefit and Payment Parameters proposed rule. In reaction to this development, Carl Schmid, Deputy Executive Director of The AIDS Institute commented:

"Patients are complaining about high out-of-pocket costs for prescription drugs and rely on drug company copay assistance to afford them.

"Today's announcement by CCIIO is disappointing and will increase the cost patients must pay for their drugs, which is completely opposite of the Administration's desire to lower prescription drug costs for patients.

"We urge issuers and states to count copay assistance towards a beneficiary's deductible and out-of-pocket maximum.

"We look forward to working with CCIIO on refining their policy in order to address the specific policy conflict with the IRS guidance identified in the FAQ."