SB137 (2015) Detail

Relative to cost-sharing parity for oral anti-cancer therapies.


SB 137 – AS AMENDED BY THE SENATE

03/19/2015 0821s

2015 SESSION

15-0982

01/04

SENATE BILL 137

AN ACT relative to cost-sharing parity for oral anti-cancer therapies.

SPONSORS: Sen. Bradley, Dist 3; Sen. Hosmer, Dist 7; Sen. Reagan, Dist 17; Sen. Birdsell, Dist 19; Sen. Fuller Clark, Dist 21

COMMITTEE: Commerce

AMENDED ANALYSIS

This bill prohibits insurers providing benefits that cover expenses for intravenously administered, injected, and oral anti-cancer therapies from requiring an insured to pay a higher copayment, deductible, or coinsurance than for anti-cancer medications injected or intravenously administered by a health care provider.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/19/2015 0821s

15-0982

01/04

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Fifteen

AN ACT relative to cost-sharing parity for oral anti-cancer therapies.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Section; Oral Anti-Cancer Therapies; Individual. Amend RSA 415 by inserting after section 6-s the following new section:

415:6-t Oral Anti-Cancer Therapies.

I. No insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for anti-cancer medications that are injected or intravenously administered by a health care provider and patient administered anti-cancer medications, including but not limited to those orally administered or self-injected, shall require a higher copayment, deductible, or coinsurance amount for patient administered anti-cancer medication than it requires for injected or intravenously administered anti-cancer medications, regardless of the formulation or benefit category determination by the policy or plan.

II. An insurer shall not comply with paragraph I by:

(a) Increasing the copayment, deductible, or coinsurance amount required for injected or intravenously administered anti-cancer medication that are covered under the policy or plan.

(b) Reclassifying benefits with respect to anti-cancer medications.

III. In this section, “anti-cancer medication” means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.

2 New Section; Oral Anti-Cancer Therapies; Group. Amend RSA 415 by inserting after section 18-x the following new section:

415:18-y Oral Anti-Cancer Therapies.

I. No insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for anti-cancer medications that are injected or intravenously administered by a health care provider and patient administered anti-cancer medications, including but not limited to those orally administered or self-injected, shall require a higher copayment, deductible, or coinsurance amount for patient administered anti-cancer medication than it requires for injected or intravenously administered anti-cancer medications, regardless of the formulation or benefit category determination by the policy or plan.

II. An insurer shall not comply with paragraph I by:

(a) Increasing the copayment, deductible, or coinsurance amount required for injected or intravenously administered anti-cancer medication that are covered under the policy or plan.

(b) Reclassifying benefits with respect to anti-cancer medications.

III. In this section, “anti-cancer medication” means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.

3 Health Service Corporations; Oral Anti-Cancer Therapies; Effective Until October 1, 2017. Amend RSA 420-A:2 to read as follows:

420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:6-t, RSA 415:18, V, [RSA 415:18, VII(g),] RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-x, RSA 415:18-y, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

4 Health Service Corporations; Oral Anti-Cancer Therapies; Effective October 1, 2017. RSA?420-A:2 is repealed and reenacted to read as follows:

420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

5 Health Maintenance Organizations; Oral Anti-Cancer Therapies; Effective Until October 1, 2017. Amend RSA 420-B:20, III to read as follows:

III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:6-t, [RSA 415:18, VII(g),] RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA?415:18-v, RSA 415:18-w, RSA 415:18-x, RSA 415:18-y, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

6 Health Maintenance Organizations; Oral Anti-Cancer Therapies; Effective October 1, 2017. RSA 420-B:20, III is repealed and reenacted to read as follows:

III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:18, VII-a, RSA?415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

7 Effective Date.

I. Sections 4 and 6 shall take effect October 1, 2017 at 12:01 am.

II. The remainder of this act shall take effect January 1, 2016.

Links

SB137 at GenCourtMobile

Action Dates

Date Body Type

Bill Text Revisions

SB137 Revision: 28218 Date: Dec. 16, 2015, midnight

Docket