HHS, CMS confuse on payment assistance for exchanges
A brief issued by CMS on Monday appears to take a more negative view of company co-pay assistance to patients than did a letter sent last week by HHS Secretary Kathleen Sebelius to Rep. Jim McDermott (D-Wash.). Companies were initially relieved by Sebelius' letter, which said plans sold through the Affordable Care Act's exchanges were not subject to federal anti-kickback statutes -- clearing the way for drug companies to provide copay assistance (see BioCentury Extra, Oct. 30).
However in Monday's memo, CMS said HHS "discourages" premium and cost-sharing assistance provided by third parties to patients enrolled in plans offered on the exchanges. CMS is part of HHS. The memo states that HHS has "significant concerns" about "hospitals, other healthcare providers, and other commercial entities" providing financial assistance to patients, as the assistance could disproportionately "skew the insurance risk pool" by potentially increasing the enrollment of already ill people. ...