LR 214 – Nebraska

Status: Inactive / Dead
Year Introduced: 2021
Link: https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=46499

The purpose of this resolution is to examine and analyze how state regulated health plans and state employee health plans use programs to limit contributions made by, or on behalf of, a consumer, known as copay accumulator adjustment programs. The issues addressed by this interim study include, but are not limited to, an examination of: (1) What year such health plan or pharmacy benefit manager initiated a copay accumulator adjustment program; (2) All years the health plan or pharmacy benefit manager utilized copay accumulator adjustment programs; (3) The number of consumers affected by a copay accumulator adjustment program for each year the program has been in place; (4) The average deductible and out-of-pocket maximums of consumers affected by a copay accumulator adjustment program, per tier level if applicable; (5) Whether copay accumulator adjustment programs are implemented across all health plan policies or restricted based on other factors including, but not limited to, disease state, type of plan, type of drug or treatment, and whether such drug or treatment has a generic equivalent; (6) The yearly amount of money excluded from all consumers’ out-of-pocket costs per health plan and how the savings were utilized; and (7) The premium amounts paid by health plans, employers, and consumers for the two years before the copay accumulator adjustment program and all years after the copay accumulator adjustment programs were implemented.

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