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HHS final rule a win for copay accumulator adjustment programs

from Policy & Medicine

HHS final rule a win for copay accumulator adjustment programs Policy & Medicine On May 14, 2020 the Department of Health and Human Services (HHS) finalized the Notice of Benefit and Payment Parameters for 2021 (2021 NBPP Final Rule) that addressed whether drug manufacturer coupons must be applied towards the annual limitation on out-of-pocket costs (cost sharing). As finalized, direct support offered by a drug manufacturer for specific prescription drugs may be counted toward an enrollee’s annual limitation on cost sharing provided the support does not conflict with any state law. Insurance companies and states are provided flexibility in choosing whether to exclude or count direct manufacturer support for any prescription drug toward the annual limits. The final rule goes into effect on July 13, 2020. READ MORE

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