S.864 - 119th Congress (2025-2026): HELP Copays Act
Summary: S.864 — 119th Congress (2025-2026) All Information (Except Text) A summary is in progress.
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Summary: S.864 — 119th Congress (2025-2026) All Information (Except Text) A summary is in progress.
The HELP Copays Act requires insurers and PBMs to count all payments they receive on a patient's behalf toward their annual deductibles and out-of-pocket limit, ensuring that patients have access to their medication.
FOR THE HELP COPAYS ACT As of Fe. ary 2025 1. WHAT DOES THE HELP COPAYS ACT DO? The Help Ensure Lower Patient Copays Act (HELP Copays Act) is bipartisan legislation that would hold insurers and pharmacy benefit manage...
The HELP Copays Act [S.864] would require insurers and pharmacy benefit managers (PBMs) to count copay assistance payments they receive on behalf of patients toward those patients’ annual deductible and out-of-pocket limit.
The Help Ensure Lower Patient (HELP) Copays Act has been reintroduced in the 119th Congress and requires health plans to apply the value of copay assistance programs—including coupons and discount cards—toward patient...
On March 7, 2025, Sens. Roger Marshall (R-Kansas) and Tim Kaine (D-Virginia) reintroduced the Help Ensure Lower Patient (HELP) Copays Act (S.864). This bipartisan legislation will ensure vulnerable patients can access...
A bill to amend title XXVII of the Public Health Service Act to apply financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes.
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
The HELP Copays Act represents the most significant potential shift in this space, but state enforcement and litigation trends underscore that PBMs must act now to review plan designs, contractual provisions, and comp...
The bipartisan HELP Copays Act would prohibit the use of “copay accumulator” schemes that health plans and pharmacy benefit managers (PBMs) developed to pocket a patient’s copay assistance by excluding the cost-sharin...