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HB18-1370

Drug Coverage Health Plan

Concerning a prohibition against excluding a drug from a health coverage plan if the drug was approved by the plan for coverage of the covered person at the time the covered person enrolled in the plan.
Session:
2018 Regular Session
Subjects:
Health Care & Health Insurance
Insurance

The bill prohibits a health insurance carrier from excluding or limiting a drug under a health benefit plan and from moving the drug to a disadvantaged tier in the plan formulary if the drug was covered at the time the covered person enrolled in the plan. A carrier may not increase the amount that a covered person pays for a copayment, coinsurance, or deductible or set limits while the covered person is covered by the health benefit plan for drugs that were covered when the person became covered under the plan.

If a carrier uses a tiered plan, the carrier may not move a drug to a disadvantaged tier under specified circumstances.

A carrier may limit coverage for a drug or biosimilar product if a provider prescribes a generic drug or biosimilar product to treat the covered person's medical condition instead of the originally-prescribed drug and the covered person agrees.


(Note: This summary applies to this bill as introduced.)

Status

Introduced
Lost

Bill Text

Sponsors

Sponsor Type Legislators
Prime Sponsor

Rep. D. Esgar, Rep. J. Singer
Sen. C. Jahn

Sponsor

Co-sponsor