The undersigned organizations write to you in support of SB 290 – Out-of-Pocket Maximums and Cost-Sharing Requirements – Calculation. Our 26 organizations represent and care for Marylanders living with chronic and rare conditions who rely on high-cost specialty drugs. In recent years, health insurers have been implementing new programs called “copay accumulator adjustment programs” that do not count payments from copay assistance toward patients’ deductibles and out-of-pocket maximums. In other words, the assistance is not actually helping patients afford their high-cost treatments, forcing them to choose between their health and financial stability. SB 290 will help Marylanders continue to access the treatments they need by requiring that all payments made by or on behalf of a patient count toward their cost sharing obligations.