AN ACT TO ENACT THE PSYCHOLOGY INTERJURISDICTIONAL COMPACT, ALLOW LICENSED MARRIAGE AND FAMILY THERAPISTS TO CONDUCT FIRST-LEVEL COMMITMENT EXAMINATIONS, ELIMINATE REDUNDANCY IN ADULT CARE HOME INSPECTIONS, RAISE AWARENESS OF LUPUS AND CREATE THE LUPUS ADVISORY COUNCIL, ENSURE THE PROPER ADMINISTRATION OF STEP THERAPY PROTOCOLS, ENSURE EQUAL COVERAGE FOR ORAL ANTICANCER DRUGS MODERNIZE MEDICAID TELEMEDICINE POLICIES, INCREASE ACCESS TO TELEHEALTH SERVICES, AND CREATE THE NORTH CAROLINA HEALTHCARE SOLUTIONS TASK FORCE.
House committee substitute to the 4th edition makes the following changes.
Deletes the proposed provisions of new GS 58-3-282, concerning coverage for certain anticancer drugs, and instead provides the following provisions. Limits the scope of the statute to health benefit plans sold on the individual market that provide 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. Prohibits health benefit plans from imposing a copayment, coinsurance percentage, or deductive or any combination thereof to the insured for oral originator oncology products that are greater than that charged to the insured for intravenously administered or injected anticancer drugs. Defines coinsurance percentage. Deems an 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 originator oncology product to be in compliance with the requirements. Defines cost-sharing requirements. Provides for the limit amount described to be indexed for subsequent years, as specified, and requires the price indexed maximum cost-sharing amount be posted by the Commissioner of Insurance by April 1 of each year, applicable to policies renewed and purchased the following calendar year. Exempts plans that do not meet the minimum essential coverage requirement of the Patient Protection and Affordable Care Act, a grandfathered or transitional plan under the Affordable Care Act, a high deductible health benefit plan or policy qualified to be used in conjunction with a health savings account, a medical savings account, or other similar program authorized by specified federal law.
Maintains that the provisions apply to insurance contracts issued, renewed, or amended on or after January 1, 2020, and that the statute will not become effective if it is determined by the federal government to create a state-required benefit in excess of the essential health benefits pursuant to 45 C.F.R. 155.170(a)(3); if such a determination is made, then requires the Department of Insurance to notify the Revisor of Statutes.
Increases the membership of the North Carolina Healthcare Solutions Task Force (Task Force) required to be convened by the North Carolina Area Health Education Centers Program. Adds two members from the medical school of a private institution of higher education, one each appointed by the President Pro Tempore of the Senate and the Speaker of the House of Representatives.
Amends the act's short title.
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