AN ACT TO REQUIRE COVERAGE FOR ORALLY ADMINISTERED ANTICANCER DRUGS DURING COVID-19 STATE OF EMERGENCY.
Includes whereas clauses.
Sets out the following requirements for every health benefit plan offered in this State 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: (1) requires the health benefit plan to cover prescribed, orally administered anticancer drugs on a basis that is no less favorable than the plan's coverage for intravenously administered or injected anticancer drugs; and (2) specifies that coverage for orally administered anticancer drugs is not subject to any prior authorization, dollar limit, copayment, coinsurance, or deductible provision or to any other out-of-pocket expense that does not apply to intravenously administered or injected anticancer drugs. Gives the Commissioner of Insurance enforcement authority and allows for the adoption of temporary rules. Prohibits an insurer from complying with this act by increasing expenses imposed on anticancer drugs. Requires any health benefit plan change increasing an out-of-pocket expense applied to anticancer drugs to also be applied to the majority of comparable medical or pharmaceutical benefits covered by that health benefit plan. Expires 60 days after the date Executive Order No. 116, Declaration of a State of Emergency to Coordinate Response and Protective Actions to Prevent the Spread of COVID-19, expires or is rescinded.
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