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Putting an End to Accumulator Adjustment Programs

posted: August 3, 2020

OAR is taking action to ensure that insurers and pharmacy benefit managers are required to count prescription drug copay assistance toward a patient’s out-of-pocket, or deductible. Copay accumulator policies are increasingly making it more difficult for our most vulnerable patients to afford prescription medications. House Bill 469 addresses the negative insurer and PBM practice of no longer counting copay assistance toward a patient’s cost-sharing obligation. OAR submitted written testimony to the House Health Committee in June in support of this legislation.

Read OAR’s Written Testimony on HB 469

On the federal front, OAR opposes the Health and Human Services (HHS) Rule on the 2021 Notice of Benefit and Payment Parameters (NBPP) which includes a provision that allows for health plans to disregard patients’ use of co-pay assistance toward paying down their cost-sharing obligation. OAR signed-on to two letters along with dozens of other organizations expressing disappointment in the recent changes in the NBPP.

Read the Full Letter

OAR remains committed to Ohio efforts to restrict insurers from excluding patient copay assistance and will update membership on new developments.