HF 1190

as introduced - 88th Legislature (2013 - 2014) Posted on 03/04/2013 02:21pm

A bill for an act
relating to insurance; establishing cost-sharing criteria for generic and
over-the-counter drugs offered by qualified health plans.

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

Section 1. new text begin REQUIREMENTS FOR QUALIFIED HEALTH PLANS.
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new text begin Subdivision 1. new text end

new text begin Cost sharing for drugs. new text end

new text begin Each qualified health plan offered through
a Minnesota health insurance exchange:
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new text begin (1) must provide coverage for generic prescription drugs without co-payments,
coinsurance, or other enrollee cost sharing; and
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new text begin (2) may provide coverage for over-the-counter drugs without co-payments,
coinsurance, or other enrollee cost sharing, if the issuer of the qualified health plan
determines that the over-the-counter drug is an appropriate and cost-effective substitute
for a formulary legend drug.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions apply.
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new text begin (b) "Affordable Care Act" means Public Law 111-148, as amended by the federal
Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any
amendments to, or regulations or guidance issued under, those acts.
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new text begin (c) "Cost-effective" means the cost to the issuer of the qualified health plan of
providing the over-the-counter drug without cost sharing is less than the cost to the issuer
of providing the formulary legend drug, after any applicable enrollee cost sharing.
new text end

new text begin (d) "Minnesota health insurance exchange" means the health benefit exchange
established by the state in compliance with section 1311 of the Affordable Care Act.
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new text begin (e) "Qualified health plan" has the meaning provided in section 1301 of the
Affordable Care Act.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014.
new text end