Although the planned date of introduction was pushed back by a few days, on June 12th the Improving Seniors’ Timely Access to Care Act was reintroduced. RNS was proud to join as an endorsing organization. Already the legislation has 146 cosponsors in the House, which is not surprising given that the bill passed the House unanimously in the last Congress. This legislation has overwhelming bipartisan support, enjoys endorsements from hundreds of healthcare organizations, and now has a negligible Congressional Budget Office score, all of which makes it a strong contender for enactment before the end of this year.
On June 24, RNS joined seventy-five other patient and provider groups to write the Departments of Health and Human Services, Treasury, and Labor about the need for regulatory clarity related to copay accumulators. As a reminder, last year a federal court struck down the regulation allowing the use of these insurer programs in the Affordable Care Act exchanges. Following that ruling, the agency reverted to its previous regulatory paradigm, which requires insurers to count copay assistance towards a patient’s cost-sharing, unless it is used for a drug that has a clinically appropriate generic equivalent. The Department of Health and Human Services (HHS) also declared its intent to revise the existing rule.
With that in mind, the letter that RNS joined asks for three key policies:
- Maintain the patient protections from the current regulatory approach, namely, requiring insurers to count copay assistance payments toward a patient’s annual deductible and out-of-pocket limit.
- Prohibit the use of copay accumulators for a preferred medication, regardless of whether that is the brand or the generic. Additionally, if the preferred version is not appropriate for a particular patient, create an exception to prohibit the use of copay accumulators for the version that is appropriate for the patient.
- Ensure that any provision allowing copay accumulators in the context of Health Savings Accounts (HSAs) be strictly limited to people for whom using copay assistance would result in ineligibility to contribute to the HSA.
RNS will continue to push for enactment of the HELP Copays Act, which would codify into federal law a prohibition on the use of copay accumulators in the exchanges. However, in the meantime, we will continue to work with the relevant agencies to ensure that commonsense patient protections such as the ones outlined above are promulgated via regulatory action.
As a reminder, if you’d like to become more involved in our advocacy work, please drop us a line: advocacy@rnsnurse.org.