Republican Sen. Tom Wright and Democratic Rep. Lindsay Cross have filed legislation requiring copay assistance payments to count toward patients’ health insurance deductibles.
The bills (SB 228/HB 363) specifically target “copay accumulators,” which are copay assistance payments accepted by pharmacy benefit managers (PBMs) and insurance companies on behalf of patients but do not apply to deductibles, out-of-pocket maximums, or co-payment responsibilities.
The legislation would require that all money paid to PBMs and insurance companies for prescription drugs be applied to a patient’s deductible, out-of-pocket maximum, and co-payment responsibility no matter who paid.
“Regardless of where it comes from, money accepted by PBMs and insurance companies for prescription drugs should count toward the patient’s deductible and out-of-pocket maximum. PBMs and insurance companies should not be allowed to double-dip at the expense of patients who are struggling with chronic illness,” Wright said.
Cross added, “I’m incredibly proud to be sponsoring this patient-focused legislation because Floridians deserve financial relief for costly prescriptions. Patients with chronic or life-threatening illnesses often rely on innovative medicines to prolong and improve their quality of life. It is disingenuous for insurance companies and PBMs to profit from copay assistance without passing on the benefits to patients. This bill will