As uncertainty persists around federal policies regarding copay accumulator programs, a growing number of states are stepping in. A total of 21 states have banned the programs and others are increasing transparency requirements
Copay Accumulator & Maximizer Programs Threaten Access to Treatment
As health insurance companies and third-party benefit managers continue to use copay accumulators and maximizers to shift the cost of specialty drugs to patients, the ACR continues to advocate against programs that limit copay assistance.
Slow but Steady: 2023 State Legislative Progress
This legislative season has seen key pharmacy benefit manager reforms but slow movement on other issues, such as copay accumulators and utilization management. The ACR is also monitoring emerging topics, such as biomarker testing and post-public health emergency telehealth reforms.
What to Expect in Healthcare Policy from the 2023 State Legislative Sessions
With 2023 state legislative sessions underway, early prevailing themes may forecast areas where we will see gains this year. Key issues include utilization management, copay accumulator bans, white bagging and pharmacy benefit manager reform.
A Primer on Copay Accumulator Programs
The growing use of copay accumulator programs, which restrict the application of patient assistance funds toward cost-sharing requirements, hurts patient access to life-changing treatments. This was one topic discussed during the ACR’s Advocacy Leadership Conference in D.C. this May.
Advocacy Leadership Conference: Reflections from an Accidental Rheumatology Advocate
At my first Advocacy Leadership Conference as a member of the ACR’s Insurance Subcommittee, I discovered the power of stories from the clinic and how lawmakers value clinicians’ input on healthcare legislation.
ACR Leaders to Meet with Members of Congress at May 12 Capitol Hill Event
The meetings will focus on legislation affecting rheumatology, including bills on graduate medical education and use of copay assistance funds.
State Legislative Issues to Watch in 2022
States increasingly take the lead on issues critical to our members and the field of rheumatology, including copay accumulator bans, white bagging restrictions, prior authorization and drug pricing.
Spring Review of 2021 State Legislative Progress
Bright spots from this legislative session include utilization management reform, copay accumulator bans and pharmacy benefit manager reform.
What to Expect in State Legislatures in 2021
New state legislatures face many continuing issues, including budget shortfalls, vaccine distribution problems and strained healthcare infrastructure. However, opportunities exist for significant policy wins for rheumatology, particularly on the issues of step therapy reform, telemedicine and copay accumulators.