CMS Allows Exchange Plans Limited Use Of Copay Accumulators

CMS announced Thursday (April 18) that it will allow exchange plans to stop allowing copay coupons from drug makers to count toward enrollees’ out-of-pocket maximums when generic equivalents are available. The proposal is at odds with approaches taken by state legislatures in Virginia and West Virginia this year, which banned plans sold on individual markets from using copay accumulators. “We expect this change to support issuers’ and plans’ ability to lower the cost of coverage and generate cost savings while...