CLL Society supports the Help Ensure Lower Patient Copays Act. Even as the out-of-pocket costs in Medicare have been capped by Congress, our patients continue to have problems affording treatments on the commercial insurance side. The questionable practice of middlemen – Pharmacy Benefit Managers (PBMs) – that do not allow financial assistance payments to count towards patients’ annual deductibles and out-of-pocket caps directly reduce our patients’ ability to afford lifesaving medications believes that receiving care through telehealth.
The Help Ensure Lower Patient Copays Act would require health plans to count prescription drug copay-assistance payments to count toward annual deductibles and out of pocket limits. It would also prohibit employer plans from identifying some drugs as ‘non-essential’ to get around legal protections on out of pocket costs.