Jeanette Hoffman, executive director, Patients Come First - New Jersey | PatientsComeFirst.com
Jeanette Hoffman, executive director, Patients Come First - New Jersey | PatientsComeFirst.com
The head of a New Jersey health care reform group said that copay accumulators are leading to unexpected healthcare costs for local patients.
"Many New Jerseyans are concerned about accessing their prescription drugs, particularly those living with chronic illnesses," wrote Jeannette Hoffman, executive director of Patients Come First - New Jersey, in a TAPinto Phillipsburg op-ed. "Fortunately, there are many assistance programs provided by drug manufacturers to help offset drug costs, including co-pay assistance programs, which dramatically reduce out-of-pocket costs for patients."
"However, the majority of insurance companies are now using co-pay accumulator adjustment programs, which disallow copay assistance from counting towards a patient’s annual deductible or out-of-pocket maximum," Hoffman wrote. "As a result, patients can be faced with unexpected costs of up to thousands of dollars to get the medicines they need."
A copay accumulator is a program used by some health insurers in the United States that does not count copay assistance payments toward a patient's deductible or out-of-pocket maximum.
Twenty states, plus Washington, D.C. and Puerto Rico, require insurers to count all payments made by patients, even those from patient assistance programs, count toward the patient’s out-of-pocket maximum.
New Jersey is not one of those states.
"Patients should be able to use every assistance program available to access life-saving medicines," wrote Hoffman. "To ensure patients are at the forefront of healthcare decision-making, our lawmakers should reform copay accumulator adjustment programs, currently implemented by 80 percent of commercial insurance plans."
In addition to running a public affairs firm, Marathon Public Affairs, Hoffman previously worked as vice president of government affairs and communications for The Commerce and Industry Association of New Jersey. She also previously worked as an aide to former Gov. Christine Todd Whitman (R-N.J.).
Patients Come First has also launched groups in California and Missouri.
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