Judge Strikes Down Trump-Era Medicare Copay Assistance Rule (1)

The Medicare agency must withdraw a Trump-era rule on copay assistance programs under a federal judge’s order following claims from drug industry-backed patient groups that the policy has allowed health plans to increase out-of-pocket prescription drug costs for consumers.

The rule (RIN 0938-AT98) from the Centers for Medicare & Medicaid Services appears to conflict with the definition of “cost-sharing” in the Affordable Care Act and federal regulations, Judge John D. Bates wrote in an order filed Friday in the US District Court for the District of Columbia. The 2020 rule said pharmacy benefit managers—the entities that manage prescription drug benefits ...