VA will wait to raise drug copayments

(MILITARY TIMES)   A $1 increase in copayments for outpatient medications for veterans who do not qualify for free prescriptions is being delayed for six months while the Veterans Affairs Department reviews its options.

Copayments are required for a 30-day supply of medication provided on an outpatient basis to people being treated for disabilities or conditions that are not related to military service. Copayments are not charged for veterans who have service-connected disabilities rated at 50 percent or more, regardless of whether they are being treated for a service-connected issue, and copayments are waived for some low-income veterans.

The current charge of $8 was supposed to rise to $9 on Jan. 1 under regulations that call for prescription drug charges to keep pace with prescription drug charges in the private sector.

But on Dec. 31, VA officials announced in the Federal Register that they were delaying the increase until July 1 so they could reconsider how increases are calculated. This delays both the $1 hike and a $120 increase in the $960 copayment cap on drug costs for veterans who have service-connected disabilities but are being treated for nonservice-related medical issues.

“We need time to determine whether an increase might pose a significant financial hardship for certain veterans and, if so, what alternative approach would be appropriate relief for these veterans,” the statement says.

Created in 2002, the copayment cap began as a $2 fee for a 30-day prescription but increased to $7 in 2008 and to $8 in 2009.

Under VA rules, the drug copayment is supposed to increase each Jan. 1 based on the increase in the prescription drug portion of the Medical Consumer Price Index, a measurement maintained by the Labor Department’s Bureau of Labor Statistics.

The drug index, known as CPO-P, called for an automatic $1 increase that can be delayed under current law but still has to take effect at some point.

VA officials called their action a “temporary freeze,” with the expectation that the increase will take effect this summer unless a new way of calculating and applying the copayment is found.

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