House amendment to the 3rd edition makes the following changes.
Amends GS 58-3-282 to add that any insurer that limits the total amount paid by a covered person through all in-network, cost-sharing requirements to no more than $300 per filled prescription for any oral anticancer drug will be considered in compliance with the statute. Provides for what is included in cost-sharing requirements.
NC CANCER TREATMENT FAIRNESS ACT.
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View NCGA Bill Details(link is external) | 2013-2014 Session |
A BILL TO BE ENTITLED AN ACT RELATING TO HEALTH BENEFIT PLAN COVERAGE FOR ORALLY ADMINISTERED ANTICANCER DRUGS.Intro. by Lewis, T. Moore, L. Hall, Burr.
Bill History:
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Mon, 8 Apr 2013 House: Filed(link is external)
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Tue, 9 Apr 2013 House: Passed 1st Reading(link is external)
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Tue, 9 Apr 2013 House: Ref To Com On Health and Human Services(link is external)
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Wed, 24 Apr 2013 House: Reptd Fav Com Substitute(link is external)
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Wed, 24 Apr 2013 House: Cal Pursuant Rule 36(b)(link is external)
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Wed, 24 Apr 2013 House: Placed On Cal For 04/25/2013(link is external)
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Thu, 25 Apr 2013 House: Withdrawn From Cal(link is external)
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Thu, 25 Apr 2013 House: Re-ref Com On Insurance(link is external)
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Tue, 7 May 2013 House: Reptd Fav Com Sub 2(link is external)
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Tue, 7 May 2013 House: Cal Pursuant Rule 36(b)(link is external)
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Tue, 7 May 2013 House: Placed On Cal For 05/08/2013(link is external)
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Wed, 8 May 2013 House: Amendment Withdrawn A1(link is external)
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Wed, 8 May 2013 House: Passed 2nd Reading(link is external)
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Thu, 9 May 2013 House: Amend Adopted A2(link is external)
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Thu, 9 May 2013 House: Passed 3rd Reading(link is external)
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Thu, 9 May 2013 House: Ordered Engrossed(link is external)
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Mon, 13 May 2013 Senate: Rec From House(link is external)
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Mon, 13 May 2013 Senate: Passed 1st Reading(link is external)
Bill Summaries:
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Bill H 609 (2013-2014)Summary date: May 9 2013 - View Summary
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Bill H 609 (2013-2014)Summary date: May 7 2013 - View Summary
House committee substitute makes the following changes to the 2nd edition. Renumbers the proposed statute as GS 58-3-282. Makes the statute applicable to every health benefit plan offered by an insurer (was, every policy or contract of accident or health insurance and every preferred provider benefit plan) 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. Deletes the provision that stated nothing in the statute applies to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policies.
Changes the effective date of the act from January 1, 2014, to January 1, 2015. Adds that the act 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).
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Bill H 609 (2013-2014)Summary date: Apr 24 2013 - View Summary
House committee substitute to the 1st edition makes the following changes.
Amends proposed GS 58-51-59.1 to require every policy or contract of accident or health insurance and every preferred provider benefit plan under GS 58-50-56 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 (was, that provides coverage for cancer treatment) must provide coverage for prescribed, orally administered anticancer drugs (was, orally administered anticancer drugs that are used to kill or slow the growth of cancerous cells) on a basis no less favorable than the coverage provided for the intravenously administered or injected anticancer drug. Also amends the statute to provide that nothing in the statute applies to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policies.
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Bill H 609 (2013-2014)Summary date: Apr 8 2013 - View Summary
Enacts new GS 58-51-59.1 requiring every policy or contract of accident or health insurance and every preferred provider benefit plan that provides coverage for cancer treatment to provide coverage for prescribed, oral anticancer drugs that kill or slow the growth of cancer cells on a basis no less favorable than provided for intravenously administered or injected cancer drugs. 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 dose not apply to intravenously administered or injected anticancer drugs. Prohibits achieving compliance by reclassifying drugs or increasing expenses imposed on anticancer drugs.
Applies to insurance contracts issued, renewed, or amended on or after January 1, 2014.