News Briefs

In its final Notice of Benefit and Payment Parameters for the 2021 benefit year, CMS crystallized a controversial policy of allowing commercial health insurers to prevent drug manufacturer coupons from counting toward members’ annual out-of-pocket limits. So-called copay accumulator programs, in the eyes of health insurers, help prevent drug coupons from steering patients to higher-priced, brand-name drugs by obscuring their true cost (RDB 3/12/20, p. 4). But drugmakers and some patient advocacy organizations contend that copay accumulators stop patients from getting crucial help to pay for their medications. Read the final rule at https://go.aws/2Any1WY.

Maryland Gov. Larry Hogan, a Republican, vetoed funding for a board that would have set maximum prices that the state and local governments would have to pay for certain medicines. In a letter to legislators on the matter, the governor said he made the move to prevent increasing taxes during the emerging pandemic-driven economic catastrophe. The board’s supporters criticized the governor’s decision, arguing price controls would have protected vulnerable consumers, and that the program would be paid for by fees assessed to drugmakers, PBMs and insurance companies, according to an article from Stat. Read Hogan’s letter to legislators at https://bit.ly/2T1VdjQ and the Stat article at https://bit.ly/2YZ0DQt.

© 2021 MMIT

AIS Health Staff

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