The Centers for Medicare and Medicaid Services wants clarification from the federal court that recently ruled against the agency’s interpretation of the law when it comes to commercial insurance plans’ use of copay accumulators before it revises its current policy on such programs.
Key Takeaways
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Government will not take enforcement action against copay accumulators used for brands without generic competition until it gets further clarification from federal court about a recent decision involving accumulator programs.
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HHS has also appealed the decision
The Health and Human Services Department filed a motion with the US District Court for the District of Columbia on 27 November seeking an explanation for the court’s late September decision that the policy, which allows plans to use copay accumulators broadly, must be set aside and remanded back to CMS because of the agency’s contradictory reading of the same statutory and regulatory language
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