Editor’s note Nov. 23, 2020: As of Nov. 12, 2020, UHC has delayed implementation of the policy discussed below. See “UnitedHealthcare Delays Copay Accumulator Policy.”
UnitedHealthcare (UHC) announced that, as of Jan. 1, 2021, providers will be required to report the amount their patients receive in copay assistance for office-administered treatments. UHC will then use this information to enforce a copay accumulator, ensuring that no copay assistance funds are applied toward patients’ deductibles or out-of-pocket maximum payments.
The ACR has serious concerns about the impact of this policy on patients’ ability to access treatment. When an accumulator is enforced, copay assistance funds are exhausted in the middle of the plan year and patients are forced to pay out of pocket, or discontinue or switch treatments. The policy also places providers in an ethically objectionable position by requiring they report information that would be used to harm patients.
The ACR strongly opposes this policy and has urged UHC to explore other ways to rein in drug costs without jeopardizing patients’ health. Earlier this week, the ACR led a coalition of 12 provider and patient organizations that sent a letter to UHC advocating against implementation of this policy.
We are eager to engage UHC in further dialogue and will continue to push for the policy to be completely rescinded.
If you have questions regarding this policy or other insurance coverage concerns, contact practice@rheumatology.org.