Bill > H3575

This bill amends South Carolina insurance laws to regulate cost-sharing practices for health plans and pharmacy benefit managers, introducing new provisions that aim to protect consumers and ensure transparency in healthcare pricing. The bill defines key terms like "cost sharing" (copayments, coinsurance, deductibles) and establishes rules for how insurers and pharmacy benefit managers calculate and apply these costs. Specifically, the legislation requires insurers to include all cost-sharing amounts paid by or on behalf of an enrollee when determining their contribution, with some exceptions for Health Savings Account-qualified plans. The bill prohibits insurers from altering health plan coverage terms based on the availability of financial assistance for prescription drugs and applies the new regulations to health plans entered into or renewed on or after January 1, 2027. Additionally, the bill updates definitions related to pharmacy benefits managers, healthcare insurers, and related services, and ensures that the state will only regulate insurers and health benefit plans to the extent permissible under applicable law. The changes are designed to provide more clarity and consumer protections in healthcare cost-sharing practices, with the director of insurance given the authority to create necessary rules and regulations for implementation.

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https://www.scstatehouse.gov/billsearch.php?billnumbers=3575&session=126&summary=B