SF 1761

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:

Section 1.

new text begin [62A.3075] ORAL CHEMOTHERAPY CANCER TREATMENT
COVERAGE.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (c) For purposes of this section, "pharmacy" includes a pharmacy benefit manager.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin 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.
new text end