Bill > H4795

This bill amends South Carolina law to establish new requirements for health benefit plan issuers (insurance companies) when modifying drug coverage. Specifically, the bill allows drug coverage modifications only at the time of coverage renewal, and only if the changes are applied uniformly across all similar health plans. The issuer must provide written notice at least 60 days before the modification to the state commissioner, affected plan sponsors, and individual plan holders. Modifications that require notice include removing a drug from the formulary, adding prior authorization requirements, changing quantity limits, imposing step-therapy restrictions, or moving a drug to a higher cost-sharing tier without a generic alternative. The bill also gives enrollees the option to receive these notifications via email and protects patients from being coerced into waiving their rights under this law, with any such coerced waiver being deemed void. The bill will take effect upon the Governor's approval, providing more transparency and patient protections in health plan drug coverage changes.

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https://www.scstatehouse.gov/billsearch.php?billnumbers=4795&session=126&summary=B