Bill > H3537

Introduced Session

A bill to amend the South Carolina Code of Laws by adding SectionS 38-71-292 AND 38-71-820 BOTH so as to DEFINE TERMS AND REQUIRE INSURERS TO INCLUDE COST-SHARING AMOUNTS PAID WHEN CALCULATING AN ENROLLEE'S CONTRIBUTION; by adding Section 38-71-2270 so as to REQUIRE PHARMACY BENEFITS MANAGERS TO INCLUDE COST-SHARING AMOUNTS PAID WHEN CALCULATING AN ENROLLEE'S CONTRIBUTION; and by amending Section 38-71-2200, relating to Definitions, so as to define terms. Whereas, citizens of South Carolina frequently rely on state-regulated commercial insurers to secure access to the prescription medicines needed to protect their health; and Whereas, commercial insurance designs increasingly require patients to bear significant out-of-pocket costs for their prescription medicines; and Whereas, high out-of-pocket costs of prescription medicines impact the ability of patients to start new and necessary medicines and to stay adherent to their current medicines; and Whereas, high or unpredictable cost-sharing requirements are a main driver of elevated patient out-of-pocket costs and allow insurers to capture discounts and price concessions that are intended to benefit patients at the pharmacy counter; and Whereas, insurers unfairly increase cost-sharing burdens on patients by refusing to count third-party assistance toward patients' cost-sharing contributions; and Whereas, the burdens of high or unpredictable cost-sharing requirements are borne disproportionately by patients with chronic or debilitating conditions; and Whereas, restrictions are needed on the ability of insurers and their intermediaries to use unfair cost-sharing design to retain rebates and price concessions that should be directly passed on to patients as cost savings; and Whereas, patients need equitable and accessible health coverage that does not impose unfair cost-sharing burdens upon them. Now therefore,

AI Summary

Committee Categories

Pat Henegan (D)*, 

Scrivener's error corrected (on 01/31/2023)

Official Document