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2012 SESSION

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HB 1273 Chemotherapy; requirements for orally administered cancer drugs.

Introduced by: Christopher K. Peace | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED:

Health insurance; parity of coverage for oral chemotherapy medications. Provides that each health insurer, health care subscription plan, and health maintenance organization whose policies, contracts, or plans include coverage for intravenously administered, injected, and orally administered anticancer drugs shall provide that the criteria for establishing cost sharing applicable to orally administered cancer chemotherapy drugs and cancer chemotherapy drugs that are administered intravenously or by injection shall be consistently applied within the same plan. This requirement will apply to the state employees' health insurance plan and to the local choice health program. This bill is identical to SB 450.

SUMMARY AS PASSED HOUSE:

Access to oral chemotherapy medications. Provides that each health insurer, health care subscription plan, and health maintenance organization whose policies, contracts or plans include coverage for intravenously administered, injected and orally administered anticancer drugs shall provide that the durational limits, deductibles, coinsurance factors and copayments for orally administered anticancer drugs shall have consistently applied criteria within the same plan as those for cancer chemotherapy drugs that are administered intravenously or by injection. This requirement will apply to the state employees' health insurance plan and to the local choice health program.

SUMMARY AS INTRODUCED:

Access to oral chemotherapy medications; classification.  Prescribed, orally administered medications necessary for the treatment of cancer shall be available on a basis no less favorable than coverage provided for intravenously administered or injected anticancer medications, regardless of formulation or benefit category determination by the insurer, corporation, or health maintenance organization. Prescribed, orally administered anticancer medications are currently available from health insurers, health care subscription plans, and health maintenance organizations whose pharmaceutical benefit category determination provides coverage. This classification will apply to the state employees' health insurance plan and to the local choice health program.