Bill
Bill > SB256
summary
Introduced
01/23/2025
01/23/2025
In Committee
03/02/2026
03/02/2026
Crossed Over
02/26/2026
02/26/2026
Passed
Dead
Introduced Session
2025 Regular Session
Bill Summary
This bill requires a health plan to utilize the lowest cost method of reimbursement for clinician administered drugs and requires a health maintenance organization to cover clinician-administered drugs if the drug cannot reasonably be self-administered and is typically administered by a health care professional. The bill also prohibits a health maintenance organization from requiring that a pharmacy dispense a medication to a patient with the expectation that the patient will transport it to a health care setting for administration by a health care professional.
AI Summary
This bill establishes safety and care requirements for clinician-administered drugs, which are outpatient prescription drugs, excluding vaccines, that cannot be reasonably self-administered and are typically given by a healthcare professional in a clinical setting. It prohibits health insurers and pharmacy benefit managers from mandating specific pharmacies for dispensing these drugs and delivering them to a provider ("white bagging") unless there's a written agreement and provider consent. Similarly, it restricts requiring patients to transport these drugs from a pharmacy to a healthcare provider ("brown bagging") unless both the patient and provider attest that transport won't compromise care and give written consent. The bill also prevents insurers from interfering with a patient's choice of provider or pharmacy, limiting coverage based on where the drug is dispensed, or imposing additional costs on patients when drugs are not dispensed by a pharmacy chosen by the insurer. Furthermore, it ensures that providers are not penalized for obtaining these drugs from pharmacies outside the insurer's network, as long as medical necessity criteria are met.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (5)
Last Action
Vacated and Referred to Commerce and Consumer Affairs (Rep. Kofalt): Motion Adopted Voice Vote (in recess of) 02/19/2026 House Journal 5 (on 03/02/2026)
Official Document
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