NC CANCER TREATMENT FAIRNESS ACT.

View NCGA Bill Details2013-2014 Session
House Bill 609 (Public) Filed Monday, April 8, 2013
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.

Status: Ref to Health Care. If fav, re-ref to Insurance (Senate Action) (May 13 2013)
H 609

Bill Summaries:

  • Summary date: May 9 2013 - More information

    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.


  • Summary date: May 7 2013 - More information

    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).

     


  • Summary date: Apr 24 2013 - More information

    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.


  • Summary date: Apr 8 2013 - More information

    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.


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