Bill > SB422

This bill establishes new requirements for health insurance coverage related to advanced or metastatic cancer. Specifically, the bill prohibits insurers from requiring patients with advanced or metastatic cancer to fail or prove failure of a different drug before covering a new prescription drug that is FDA-approved and consistent with National Comprehensive Cancer Network guidelines. The bill defines advanced or metastatic cancer as cancer that has spread beyond its original site or is considered terminal, and defines terminal cancer as a condition that cannot be cured and is expected to lead to death. The legislation applies to health insurance plans in both group and individual markets and ensures that prescription drugs for advanced or metastatic cancer treatment are covered if they are supported by peer-reviewed evidence and FDA-approved. Additionally, the bill makes technical amendments to several existing state insurance laws to incorporate these new cancer treatment coverage requirements, ensuring that health maintenance organizations and self-funded multiple employer welfare arrangements are also subject to the new provisions. The intent is to reduce barriers for patients with advanced cancer in accessing potentially beneficial prescription medications and to provide more comprehensive insurance coverage for critical cancer treatments.

Budget and Finance, Business and Industry

https://bills.legmt.gov/#/laws/bill/2/LC1934