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Department of Insurance, Securities and Banking

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Annual Update to Specialty Drug Copayment Limitations

“Specialty Drug Copayment Limitation Act of 2015” (D.C. Law 21-248; D.C. Code § 48–855; Effective from Apr 7, 2017) 

Per § 48–855.02(a)(2) “On July 1 of each year, the limit on a required copayment or coinsurance applicable to a drug on a specialty tier provided in paragraph (1) of this subsection shall increase by a percentage equal to the percentage change from the preceding year in the medical care component of the March Consumer Price Index for All Urban Consumers, Washington-Baltimore metropolitan area, as published by the Bureau of Labor Statistics of the United States Department of Labor.” 

According to information from the Bureau of Labor Statistics website the annual adjustment is shown below.
 

Year 30-day Supply 90-day Supply
July 2017 $150 $300
July 2018 $153 $306
July 2019 $154 $308
July 2020 $157 $315
July 2021 $167 $336
July 2022 $177 $355
July 2023 $172 $345
July 2024 $178 $358
July 2025 $178 $359
July 2026 $181 $362