Gonzalez and Spanberger Introduce Bill to Financially Protect COVID-19 Patients
Washington, D.C. , January 26, 2021
Today, U.S. Representative Anthony Gonzalez (OH-16) and Representative Abigail Spanberger (VA-07) introduced the Protecting Patient Access to Lifesaving COVID-19 Drugs, legislation that will expand access to lifesaving COVID-19 treatments by requiring private health insurance plans to cover the administration costs of monoclonal antibodies without cost-sharing.
“Monoclonal antibodies are the only COVID-19 therapy that have consistently proven they can save lives and reduce the strain on our hospitals,” Gonzalez said. “When seeking access to these lifesaving drugs, the last thing a patient should worry about is how they will pay for them. By guaranteeing coverage and eliminating cost-sharing, my bill ensures monoclonal antibodies are affordable and accessible to every American who needs them.”
“I’ve heard directly from Central Virginians concerned about the potential for high financial costs associated with COVID-19 antibody therapies, which are very expensive and require specialized professionals to administer them. To protect consumers on private plans from these high costs, our legislation makes clear that private plans must cover antibody therapies and infusions with no cost-sharing – just as they would cover COVID-19 testing,” said Spanberger. “This bipartisan effort responds to the urgency of our current crisis, and I’d like to thank Congressman Gonzalez for his partnership on this bill. As millions of Americans are treated for COVID-19 – and millions more are vaccinated against contracting the virus – our first priority must be to make sure no American is forced to decline necessary healthcare measures, simply because they fear potential costs. Our recovery as a nation will be stronger when all Americans are able to protect themselves and their families.”
“Until a sufficient proportion of the population is vaccinated to achieve herd immunity, monoclonal antibodies for COVID-positive patients provide hope in reducing hospitalizations among high-risk patients and saving lives. Ensuring adequate insurance coverage will be critical to accessing these life-saving therapies,” said Brian Nyquist president and CEO of the National Infusion Center Association.
“Fighting this deadly disease requires many avenues from testing to prevention to treatment,” said Robert Salata, MD, STERIS Chair of Excellence in Medicine, Department of Medicine at UH Cleveland Medical Center; Program Director of the UH Roe Green Center for Travel Medicine & Global Health; and Professor of Medicine, Epidemiology and International Health at Case Western Reserve University. “It is incumbent upon us as a nation to remove any obstacles that would prevent full and complete access to any of these measures and chief among them include payment for lifesaving drugs such as antibody treatments. We are hopeful Congress agrees and votes to amend the Families First Coronavirus Response Act and the CARES Act to require group health plans and health insurance issuers to provide coverage, without cost sharing, of certain COVID-19 antibody treatments.”
Authorized by the Food and Drug Administration in November, monoclonal antibodies have proven to prevent COVID-19 infections and reduce COVID-19 related hospitalizations. The United States Department of Health and Human Services purchased 950,000 doses from Eli Lilly and another 300,000 doses from Regeneron. While these drugs will be distributed at no cost to patients, providers are able to charge an administration fee for the intravenous infusion of the antibodies a service than can cost well over $1,000.
The Protecting Patient Access to Lifesaving COVID-19 Drugs Act ensures no COVID-19 patient faces steep, out-of-pocket costs as they battle the virus. In addition, the bill requires insurers to reimburse any provider an amount that equals the negotiated rate or, if the plan or issuer does not have a negotiated rate with the provider, the cash price posted on the providers website.
Read the bill text here.