Fixes to federal program must be done on federal level, not state by state to ensure program impacts the patient population it was intended to serve.
Under the ‘copay accumulator’ practice, the insurer is collecting from both the copay program and the patient. They are getting paid twice.
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“Not passing these bills would force patients to choose between paying for their medication and paying for their families’ needs,” Shackleton said. “Not passing these bills will lead to greater health care inequity, as only those who afford it will get the best medications.”
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Have you ever gone out to dinner and used a gift certificate someone had given you? Kind of a nice treat, right? Well, imagine that you just wrapped up your meal, gave your server the gift certificate, and then were told that the restaurant will take the associated dollars but not apply it to your check. You still owe the full amount for the meal, because the money for dinner must
come from your pocket. What? Read More
It's painful to watch the position patients are put in.
Cost should never be a factor for patients with lupus, cystic fibrosis, and other chronic and life-threatening illnesses.
A group of bills before the Financial Services Committee would impose new regulations on pharmacy benefit managers, or PBMs, in Massachusetts, ranging from limits on their ability to steer consumers toward aligned corporate chains to new reporting requirements that could provide greater insight into how the managers affect health care costs.
MASSACHUSETTS PATIENTS, ADVOCATES, HEALTHCARE PROVIDERS TO LAWMAKERS: CO-PAY ACCUMULATOR PROGRAMS PUT PATIENT HEALTH AT RISK
Out of Pocket Costs
Many patients dealing with chronic diseases, diseases that have limited treatment options, such as people living with HIV or hepatitis C, take advantage of co-pay coupons offered by prescription drug manufacturers to defray the medication cost.
Accumulator
2021
Imagine going with a friend to your favorite restaurant. When the bill comes, your friend generously offers to cover it—and plops down a gift card he received for Christmas. The waiter charges the card without issue. But as you get up to leave, the waiter demands more cash.
Legislation
Thousands of Massachusetts residents risk losing access to discounts on vital prescription drugs by the end of this year without action from state lawmakers.
Insurance Practices
By Richard Pezzillo
It is no secret that healthcare costs continue to rise, with premium increases topping 58 percent since 2006, according to Kaiser Family Foundation; but what may be surprising to lawmakers on Beacon Hill, is that patient out of pocket costs, such as deductibles, co-insurance and higher specialty pharmacy tiers have outpaced premium increases by four times, which speaks directly to tactics being taken by health plans and their pharmacy benefit managers (PBMs).
PBMs
Tonight, a proposal to change copay assistance that would cost people more money in the long run. FOX 25 news reporter, Jim Morelli, has been looking into this issue, and Jim….some patients fear this is going to prevent them from getting their medication.
CoPay Assistance
Americans Across Political Parties Want the
Federal Government to Require All Copay Assistance Be Applied
Towards a Patient's Out-of-Pocket Costs
Finance
A coalition of advocacy groups representing thousands of patients in Massachusetts, today urged lawmakers on the FY ’21 Budget Conference Committee to include an extension of a law that allows thousands of patients, living with chronic diseases, to access medications needed to manage their illnesses and lead productive lives.
Accumulator
Unfortunately, PBMs are pushing insurers and large employers to adopt accumulator adjustment programs that prevent the full out‐of‐pocket cost of certain medications from counting towards a patient’s annual deductible. Under these programs, only the amount a patient pays at the pharmacy counter — after a manufacturer coupon has lowered the patient’s cost sharing — will count towards their deductible.