Enacts new GS 58-3-282, concerning coverage for certain anticancer drugs, applicable to every health benefit plan offered by an insurer that provides coverage for prescribed, orally administered anticancer drugs that are used to kill or slow the growth of cancerous cells and that provides coverage for intravenously administered or injected anticancer drugs, requiring that such plans must provide coverage for prescribed, orally administered anticancer drugs on a basis no less favorable than the coverage provided for the intravenously administered or injected anticancer drug.
Prohibits coverage for orally administered anticancer drugs from being subject to prior authorization, dollar limit, co-payment, coinsurance, deductible provision, or any other out-of-pocket expense that does not apply to intravenously administered or injected anticancer drugs.
Prohibits achieving compliance by reclassifying drugs or increasing cost-sharing expenses imposed on anticancer drugs. Provides that if out-of-pocket expenses are increased for anticancer drugs then the same must also be applied to the majority of comparable medical or pharmaceutical benefits of the policy, contract, or plan.
Applies to insurance contracts issued, renewed, or amended on or after January 1, 2016. However, provides that it does not become effective if the act is determined by the federal government to create a state-required benefit that is in excess of the essential health benefits pursuant to 45 CFR 155.170(a)(3).
NC CANCER TREATMENT FAIRNESS.
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View NCGA Bill Details | 2015-2016 Session |
AN ACT RELATING TO HEALTH BENEFIT PLAN COVERAGE FOR ORALLY ADMINISTERED ANTICANCER DRUGS.Intro. by Lewis, L. Hall, Avila, Lambeth.
Status: Ref To Com On Rules and Operations of the Senate (Senate Action) (Apr 22 2015)
Bill History:
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Wed, 18 Mar 2015 House: Filed
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Thu, 19 Mar 2015 House: Passed 1st Reading
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Thu, 19 Mar 2015 House: Ref To Com On Insurance
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Tue, 21 Apr 2015 House: Reptd Fav
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Tue, 21 Apr 2015 House: Cal Pursuant Rule 36(b)
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Tue, 21 Apr 2015 House: Added to Calendar
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Tue, 21 Apr 2015 House: Amend Failed A1
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Tue, 21 Apr 2015 House: Passed 2nd Reading
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Tue, 21 Apr 2015 House: Passed 3rd Reading
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Wed, 22 Apr 2015 House: Regular Message Sent To Senate
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Wed, 22 Apr 2015 Senate: Regular Message Received From House
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Wed, 22 Apr 2015 Senate: Passed 1st Reading
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Wed, 22 Apr 2015 Senate: Ref To Com On Rules and Operations of the Senate
H 306
Bill Summaries:
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Bill H 306Summary date: Mar 18 2015 - View Summary
View: All Summaries for Bill
Bill as filed is identical to S 390 as filed 3/24/15.