Bill > SF2214

Introduced Session

This bill relates to prescription insulin drugs and coverage by policies, contracts, or plans providing for third-party payment or prepayment of health or medical expenses that provide coverage for prescription drugs. The bill requires a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses that provides coverage for prescription drugs to cap the total amount of cost-sharing that a covered person is required to pay per prescription filled of an insulin drug to an amount not more than $75 for an up to 31-day supply of at least one type of rapid-acting prescription insulin drugs, short-acting prescription insulin drugs, intermediate-acting prescription insulin drugs, or long-acting prescription insulin drugs. “Prescription insulin drug” is defined in the bill as a prescription drug that contains insulin, is used to treat diabetes, has been prescribed as medically necessary by a covered person’s health care professional, and is a benefit covered by a covered person’s policy, contract, or plan. The bill defines “cost-sharing” as any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense imposed on a covered person. The bill does not prohibit a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses from reducing a covered person’s cost-sharing to less than $75 for up to a 31-day supply of a prescription insulin drug. The bill applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2025, by the third-party payment providers enumerated in the bill. The bill specifies the types of specialized health-related insurance which are not subject to the coverage requirements of the bill. The commissioner of insurance may adopt rules to administer the bill.

AI Summary

Committee Categories

Carrie Koelker (R)*, 

Committee report, recommending passage. S.J. 307. (on 02/15/2024)

Official Document