Court Decision on Accumulator Rule Could Encourage State Bans

Under a May 17 court decision striking down a CMS final rule slated to take effect in 2023, pharmaceutical manufacturers will not have to ensure that financial assistance provided to patients goes only to patients and not to payers under their copay accumulator and maximizer programs. However, the renewed attention to these programs could spur more states to take action of their own against them, industry experts tell AIS Health.

The Accumulator Rule (CMS-2482-F), published Dec. 31, 2020, could have resulted in patients facing increased out-of-pocket drug costs and pharma companies being held responsible for ensuring they know exactly where their assistance is going, industry experts tell AIS Health, a division of MMIT.

© 2022 MMIT
Jill Brown Kettler

Jill Brown Kettler Executive Editor

Jill oversees AIS Health’s publications and manages the health editorial staff. She joined AIS Health in 1999, and brings unique skills and energy to the company, along with an intelligent perspective on the forces reshaping the health care industry. She holds a graduate degree in health finance and management from Johns Hopkins University School of Public Health, and was formerly a consultant with Arthur Andersen, where she worked with managed care plans, hospitals and medical groups on financial issues impacting their operations.

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