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July 16, 2015

CA Committee Considers Specialty Tiers Legislation

2015-07-16 | July 13, 2015

(Sacramento, CA) The California Senate is considering a bill that would limit patients’ out-of-pocket costs for drugs on the specialty tier. The bill was most recently referred to the Senate Health Committee.

Once drugs are placed on this tier, patients no longer can pay just a simple copay amount. Instead, they must pay a percentage of the cost of the drug, which can cost hundreds, if not thousands, per prescription.

Numerous reports, including one by the Patient Advocate Foundation, have found that patients begin to neglect their medications once their out-of-pocket costs reach $200.

Even as coverage has broadened under the Affordable Care Act and Covered California, patients today are still being restricted in their health care choices by plans that force them to pay high out-of-pocket costs for their physician-prescribed medications.

More information on the legislation can be found here.