May 27, 2024

Senate approves Britto legislation to improve prescription drug affordability

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State House — The Senate today approved legislation sponsored by Sen. Robert Britto (D-Dist. 18, East Providence, Pawtucket) that would improve prescription drug affordability for cancer patients and others with chronic diseases. The bill is part of the Senate’s Rhode Island HEALTH (Holistic Enhancement and Access Legislation for Total Health) Initiative, a 25-bill legislative package aimed at improving health care access and affordability in Rhode Island.

The bill (2024-S 2720) would restrict the use of copay accumulator adjustment programs and ensure Rhode Islanders receive the total value of prescription drug assistance to afford their treatments, improving access to care for cancer patients and others with chronic disease.

“The rising costs of health care are not sustainable for our state’s working families, and this important legislation will restrict these harmful programs that allow insurance companies to shirk their fiduciary responsibilities by excluding copay assistance from cost sharing calculations,” said Senator Britto. “I am deeply grateful to be sponsoring this bill as part of the Rhode Island HEALTH Initiative, which is such a significant step toward addressing the major challenges surrounding our health care system.”

The sometimes-harmful copay accumulator adjustment program allows an individual to use copay assistance, but doesn’t count the amount of the support used toward the individual’s deductible or maximum out-of-pocket amount. This causes patients to see increased out-of-pocket costs and take longer to reach their required deductibles.

The patient assumes a greater financial responsibility, and it takes longer for them to hit their deductible. The patient is stuck paying the bill for what should have been covered through the initial assistance.

Under the legislation, any costs paid by an enrollee or on behalf of the enrollee by a third party would have to be included when calculating an enrollee’s overall contribution to any out-of-pocket maximum or cost sharing requirement.

The measure now moves to the House of Representatives, where similar legislation (2024-H 8041) has been introduced by Rep. Mia Ackerman (D-Dist. 45, Cumberland, Lincoln).

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