Drug Cost Cap: Patient Payments Cannot Exceed National Average Price.
This law aims to lower prescription drug costs for citizens. It establishes that patient cost-sharing amounts (like copayments or deductibles) for a covered drug cannot exceed the nationwide average consumer purchase price for that medication. This change applies to group and individual health plans, offering financial protection to Americans.
Key points
Out-of-pocket costs for prescription drugs are capped at the nationwide average consumer purchase price for that specific drug.
The rule applies to all health plans and insurance issuers, including those utilizing Pharmacy Benefit Managers (PBMs).
The goal is to reduce financial burdens related to essential medications dispensed by in-network pharmacies.
Expired
Citizen Poll