The Wall Street Journal: Health Insurers Discriminate Against Patients who Need Specialty Drugs?

The Wall Street Journal: Health Insurers Discriminate Against Patients who Need Specialty Drugs?

By Ed Silverman

In a final rule issued last week concerning health benefits provided by the Affordable Care Act, the federal government noted that some health insurers are using “potentially discriminatory practices” against people with certain illnesses. As a result, they are paying more for their medicines.

The U.S. Department of Health & Human Services noted that one method is to place “most or all drugs that treat a specific condition on the highest cost tiers.” This refers to rankings on formularies, the lists that insurers use to determine reimbursement coverage for their insurance plan members. By being placed on a higher tier, a consumer is required to pay a larger share of the cost of a medicine.

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