Federal :
Copay Accumulator Adjusters: On September 29, the U.S. District Court for the District of Columbia vacated the U.S. Department of Health and Human Services’ (HHS) 2021 Notice of Benefit and Payment Parameters as a result of a lawsuit brought by the HIV and Hepatitis Policy Institute et al. The 2021 NBPP allowed health insurers to not apply copay assistance from drug makers to a patient’s annual cost-sharing requirement. Currently the landscape of copay assistance is governed by the 2020 NBPP, which muddies the water further. NBDF and the All Copays Count Coalition are advocating for the Biden Administration to take action on this issue and explicitly issue a rule that requires health insurers to count all payments made by or on behalf of a patient toward the patient’s cost-sharing requirement.
American Plasma Users (APLUS) Coalition: NBDF and members of the American Plasma Users (APLUS) Coalition continue to engage with members of Congress to discuss the importance of plasma safety and supply, alongside garnering support for the newly founded Congressional Plasma Caucus. NBDF would like to thank our Coalition partners, including the Immune Deficiency Foundation (IDF) and the Hemophilia Federation of America (HFA) for joining us on the Hill for visits. NBDF is proud to serve as Chair of the APLUS coalition during the 118th Congress.
To contact your Member of Congress to join the Congressional Plasma Caucus, click here. To learn more about the APLUS Coalition, click here.
State:
Ohio: HB177, the State’s copay accumulator bill is gaining traction! On Wednesday, November 1st, the Ohio House Committee on Health Policy heard opponent testimony from health plans and PBM’s regarding copay accumulators. NBDF is grateful to advocates, including the Ohio bleeding disorders chapters and Randi Clites, for attending the testimony. Additionally, NBDF is grateful to the Committee for asking pointed questions to the health plan and PBM lobbyists about their false points in testimony. HB177 goes to a final Committee meeting and vote, on November 15th prior to moving to the House floor.
New York: Unfortunately, the New York State Department of Financial Services (DFS) have withdrawn their proposed PBM reform regulations, we look forward to engaging with DFS as they propose new regulations.
The New York State Rare Disease Working Group, the State’s Rare Disease Advisory Council with bleeding disorders community representation, will be submitting their draft report and recommendations to the Governor and Legislature in mid-November.
Washington: The state Prescription Drug Affordability Board met Oct. 20 in an organizational meeting.
Wisconsin: SB 100, a copay accumulator adjuster bill led by the Wisconsin All Copays Count Coalition, will be rolled into Sen. Felzkowski’s larger PBM reform bill. The coalition is planning a press conference to announce the introduction of the new bill Nov. 8.
