SF 1761

4th Engrossment - 86th Legislature (2009 - 2010) Posted on 05/07/2010 05:45pm

A bill for an act
relating to insurance; requiring health plans to establish equal out-of-pocket
requirements for oral chemotherapy medications and intravenously administered
chemotherapy medications; proposing coding for new law in Minnesota Statutes,
chapter 62A.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62A.3075] CANCER CHEMOTHERAPY TREATMENT
COVERAGE.
new text end

new text begin (a) A health plan company that provides coverage under a health plan for cancer
chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance
amount for a prescribed, orally administered anticancer medication that is used to kill or
slow the growth of cancerous cells than what the health plan requires for an intravenously
administered or injected cancer medication that is provided, regardless of formulation or
benefit category determination by the health plan company.
new text end

new text begin (b) A health plan company must not achieve compliance with this section
by imposing an increase in co-payment, deductible, or coinsurance amount for an
intravenously administered or injected cancer chemotherapy agent covered under the
health plan.
new text end

new text begin (c) Nothing in this section shall be interpreted to prohibit a health plan company
from requiring prior authorization or imposing other appropriate utilization controls in
approving coverage for any chemotherapy.
new text end

new text begin (d) A plan offered by the commissioner of management and budget under section
43A.23 is deemed to be at parity and in compliance with this section.
new text end

new text begin (e) A health plan company is in compliance with this section if it does not include
orally administered anticancer medication in the fourth tier of its pharmacy benefit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraphs (a) and (c) are effective August 1, 2010, and apply
to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed,
or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after
that date. Paragraph (b) is effective the day following final enactment.
new text end