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HHS Pushes Back on Accumulator Ruling, Prompting Wait-and-See Situation

MMIT quoted a recent article written by Mintz attorneys Theresa Carnegie, Xavier Hardy, and David Gilboa in a story discussing the US district court ruling that overturned a federal rule allowing health plans to exclude copayment assistance from members’ out-of-pocket costs. The article notes the Department of Health and Human Services’ current stance of refraining from immediate action.

Mintz attorneys commented, “[prior actions and statements by HHS] indicate that the agency plans to use the tools at its disposal to protect copay accumulators. The most direct way to do so would be to amend the definition of ‘cost sharing’ to exclude manufacturer copay assistance.”