SF 1761

1st Unofficial Engrossment - 86th Legislature (2009 - 2010)

Posted on 12/26/2012 11:17 p.m.

1.1A bill for an act 1.2relating to insurance; requiring health plans to establish equal out-of-pocket 1.3requirements for oral chemotherapy medications and intravenously administered 1.4chemotherapy medications;proposing coding for new law in Minnesota Statutes, 1.5chapter 62A. 1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.7    Section 1. new text begin [62A.3075] CANCER CHEMOTHERAPY TREATMENT new text end 1.8 new text begin COVERAGE. new text end 1.9 new text begin (a) A health plan company that provides coverage under a health plan for cancer new text end 1.10 new text begin chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance new text end 1.11 new text begin amount for a prescribed, orally administered anticancer medication that is used to kill or new text end 1.12 new text begin slow the growth of cancerous cells than what the health plan requires for an intravenously new text end 1.13 new text begin administered or injected cancer medication that is provided, regardless of formulation or new text end 1.14 new text begin benefit category determination by the health plan company. new text end 1.15 new text begin (b) A health plan company must not achieve compliance with this section new text end 1.16 new text begin by imposing an increase in co-payment, deductible, or coinsurance amount for an new text end 1.17 new text begin intravenously administered or injected cancer chemotherapy agent covered under the new text end 1.18 new text begin health plan. new text end 1.19 new text begin (c) Nothing in this section shall be interpreted to prohibit a health plan company new text end 1.20 new text begin from requiring prior authorization or imposing other appropriate utilization controls in new text end 1.21 new text begin approving coverage for any chemotherapy. new text end 1.22 new text begin (d) A plan offered by the commissioner of management and budget under section new text end 1.23 new text begin 43A.23 is deemed to be at parity and in compliance with this section. new text end 1.24 new text begin (e) A health plan company is in compliance with this section if it does not include new text end 1.25 new text begin orally administered anticancer medication in the fourth tier of its pharmacy benefit. new text end 2.1 new text begin EFFECTIVE DATE. new text end new text begin Paragraphs (a) and (c) are effective August 1, 2010, and apply new text end 2.2 new text begin to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed, new text end 2.3 new text begin or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after new text end 2.4 new text begin that date. Paragraph (b) is effective the day following final enactment. new text end