Today at the Utah State Capitol, Ark Founder and CEO Rebecca Yates testified before the Utah Senate Business and Labor Committee about the negative impacts of copay accumulator adjustment policies. These policies can lead to skyrocketing medical bills, and in some cases, patients not being able to afford needed medication. The use of these policies often result in copay assistance provided by non-profits and pharmaceutical companies not counting towards a patient’s deductible or out-of-pocket-maximum.
In her testimony, Yates told the Senate Committee:
“Section 1557 in the ACA describes that you are not allowed by benefit design to discriminate on the basis of disability. You’ve heard today (in previous testimony) that this does directly discriminate against people that are disabled. It is discouraging their treatments and therefore is against ACA Law. It is also not in compliance with the actual federal register release which is what they’re using to implement it. Under 45 CFR 156.130, it actually does say that they are not allowed to implement a copay accumulator if there is not a generic available. You’ve heard testimony today that there are not generics available for this. They are already in violation of federal law in multiple ways, and we need to stop it at the state level.”
Sen. Curt Bramble, R-Provo, is the chief sponsor of S.B. 184 – Prescription Cost Amendments, which would require an insurer to calculate any amounts paid on behalf of an individual towards the individual’s cost sharing requirement, and would require a pharmacy benefit manager to calculate any amounts paid on behalf of an individual towards the individual’s cost sharing requirement.
The Senate Committee gave the bill a favorable recommendation by unanimous vote today. The bill will now proceed to the full Senate.