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SF 1761

1st Unofficial Engrossment - 86th Legislature (2009 - 2010) Posted on 12/26/2012 11:17pm

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

1.7    Section 1. [62A.3075] CANCER CHEMOTHERAPY TREATMENT
1.9(a) A health plan company that provides coverage under a health plan for cancer
1.10chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance
1.11amount for a prescribed, orally administered anticancer medication that is used to kill or
1.12slow the growth of cancerous cells than what the health plan requires for an intravenously
1.13administered or injected cancer medication that is provided, regardless of formulation or
1.14benefit category determination by the health plan company.
1.15(b) A health plan company must not achieve compliance with this section
1.16by imposing an increase in co-payment, deductible, or coinsurance amount for an
1.17intravenously administered or injected cancer chemotherapy agent covered under the
1.18health plan.
1.19(c) Nothing in this section shall be interpreted to prohibit a health plan company
1.20from requiring prior authorization or imposing other appropriate utilization controls in
1.21approving coverage for any chemotherapy.
1.22(d) A plan offered by the commissioner of management and budget under section
1.2343A.23 is deemed to be at parity and in compliance with this section.
1.24(e) A health plan company is in compliance with this section if it does not include
1.25orally administered anticancer medication in the fourth tier of its pharmacy benefit.
2.1EFFECTIVE DATE.Paragraphs (a) and (c) are effective August 1, 2010, and apply
2.2to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed,
2.3or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after
2.4that date. Paragraph (b) is effective the day following final enactment.