Bill > SB175

This bill establishes new regulations for insulin drug coverage in health insurance plans in Missouri, specifically limiting the out-of-pocket costs for patients with diabetes. The legislation defines key terms such as "prescription insulin drug" as any non-intravenous insulin used to control blood glucose levels, and sets a maximum cost-sharing limit of $30 for a 30-day supply of insulin. The bill requires health carriers to calculate an enrollee's cost-sharing at the point of sale by reducing the drug price by at least 100% of all manufacturer or pharmacy rebates, ensuring that patients benefit from these discounts. Additionally, the bill includes strong confidentiality protections for rebate information, classifying such details as trade secrets that cannot be publicly disclosed. The provisions will apply to health benefit plans delivered or renewed on or after January 1, 2026, and are designed to make insulin more affordable for people with diabetes by limiting their out-of-pocket expenses and ensuring that insurance discounts are directly passed on to patients at the point of purchase.

Business and Industry

https://www.senate.mo.gov/25info/BTS_Web/Bill.aspx?SessionType=R&BillID=476