HIV patients threatened by proposed CMS rule

By The Hon. Donna Christensen, on October 8, 2020

This letter to the editor originally appeared in The Baltimore Sun.

Maryland has one of the highest rates of HIV-positive patients in the country. Unfortunately, a proposal from the Centers for Medicare and Medicaid Services (CMS) has the potential to significantly raise out-of-pocket costs and prevent access to critical treatments for as many as 32,000 Marylanders living with HIV (“Baltimore officials fear the coronavirus pandemic will exacerbate another public health issue: STD rates,” Oct. 7).

Many Marylanders with HIV are stable when they take their medication, and they often depend on cost-sharing assistance like co-pay coupons to afford the prescription drugs they need. While the proposal (CMS 2842 P) has good intentions — to ensure cost-sharing assistance benefits patients directly and not health plans — it actually has the opposite effect. The proposal would, in fact, further erode the availability of cost-sharing assistance and increase out-of-pocket prescription drug costs for patients.

The language in this proposal could have significant and far-reaching negative consequences. Many HIV treatments can significantly extend the life of patients, but these benefits are dependent on long-term medication adherence. If patients can no longer afford their medication because cost-sharing assistance has been eliminated, they cannot properly manage the virus.

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