Organizations raise concerns over HHS rule proposal on co-pay assistance


CLARKSBURG, W.Va. – Organizations are expressing their concern for a rule proposal that would affect policies related to co-pay assistance.

The Partnership to Fight Chronic Disease and the American Autoimmune Related Diseases Association are encouraging people to offer their views during a public comment period that is in effect until March 2 at 5 p.m.

The proposal, in part, would limit the amount of money applied toward a patient’s deductible to the amount of a co-pay, with the amount covered by a co-pay assistance card no longer counted toward a deductible and/or an out-of-pocket maximum.

“Consistent with this proposal, we also propose to interpret the definition of cost sharing to exclude expenditures covered by drug manufacturer coupons. Therefore, the value of these coupons would not be required to count towards the annual limitation on cost sharing.”

Proposed rule by the Health and Human Services Department

The organizations are concerned about the 1 in 2 Americans who have chronic conditions.

“In West Virginia, generally, there’s something like over half a million, 527,000 people we know have two or more chronic diseases. So, for those individuals who are taking multiple medications to manage their health, they’re paying three to five times what someone without a chronic condition might need to pay to afford their medicines. And, in our view, that’s why we want this program that’s currently in place, that offers co-pay assistance coupons, to stay in place, because these individuals, these patients with chronic conditions, absolutely need that help,” said AARDA President and CEO Randall Rutta.

To submit a comment on the proposal, click here.

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