2nd Engrossment - 86th Legislature (2009 - 2010) Posted on 04/12/2010 12:26pm
A bill for an act
relating to insurance; requiring health plans to limit out-of-pocket costs for oral
anticancer medication; proposing coding for new law in Minnesota Statutes,
chapter 62A.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
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(a) A health plan company that provides coverage under a health plan for cancer
chemotherapy treatment shall not require the total of co-payments and coinsurance to be
higher than $50 per prescription for orally administered anticancer medication, obtained
through a pharmacy, that is used to kill or slow the growth of cancerous cells, regardless
of formulation or benefit category determination by the health plan company.
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(b) 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 oral chemotherapy treatment for cancer.
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(c) For purposes of this section, "pharmacy" includes a pharmacy benefit manager.
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This section is effective August 1, 2010, and applies 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.
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