FAQ: Plans May Exclude Coupon Value from ACA Out-of-Pocket Calculation Regardless of Generic Availability

FAQ: Plans May Exclude Coupon Value from ACA Out-of-Pocket Calculation Regardless of Generic Availability

CCIIO, Treasury, and DOL say that individual and group plans may exclude the value of brand drug coupons from the calculation of ACA out-of-pocket maximums regardless of the availability of a generic alternative until further rulemaking is undertaken and finalized through the 2021 Payment Notice. In the 2020 Payment Notice, CCIIO had finalized a policy under which brand drug coupons’… (Zatorski, 8/27/19) #Qualified Health Plans, #Prescription Drugs, #Pharmacy Benefit Managers

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