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HF 1832

as introduced - 90th Legislature (2017 - 2018) Posted on 05/04/2017 10:40am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health; requiring health plans to indicate level of coverage for certain
anticancer medication; amending Minnesota Statutes 2016, section 62A.3075.

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

Section 1.

Minnesota Statutes 2016, section 62A.3075, is amended to read:


62A.3075 CANCER CHEMOTHERAPY TREATMENT COVERAGE.

(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.

(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.

(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.

(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.

(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 begin (f) A health plan company that provides coverage under a health plan for cancer
chemotherapy treatment must indicate the level of coverage for orally administered anticancer
medication within its pharmacy benefit filing with the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end