Bill > HB1971

This bill requires health insurance plans to provide reimbursement for a full 12-month refill of prescription hormone therapy obtained at one time, starting January 1, 2026. The bill defines "prescription hormone therapy" as FDA-approved drugs used to medically adjust hormone levels, excluding certain specific medications like GLP-1 drugs. The 12-month refill requirement applies only to medications that can be safely stored at room temperature and does not apply to controlled substances, for which plans must provide the maximum refill allowed by law. Health plans can still limit refills in the last quarter of a plan year if a 12-month supply has already been dispensed, and providers can temporarily limit refills to 90 days if there's an acute dispensing shortage. The bill allows health plans to continue applying drug utilization management strategies, ensuring that patients have increased access to hormone therapy while maintaining appropriate medical oversight. This legislation aims to improve patient convenience and potentially reduce healthcare administrative burdens by allowing longer-term prescription refills.