Bill > SB423

This bill requires that any cost-sharing assistance paid by or on behalf of an individual for a prescription drug be counted towards their deductible or annual out-of-pocket limit under their health benefit plan, which is a type of insurance that covers medical expenses. This applies to prescription drugs that do not have a generic equivalent or biosimilar version, or when a brand-name drug is used after obtaining prior authorization, complying with a step-therapy protocol (a process where a less expensive drug is tried first), or receiving approval through an exception or appeal process. The bill also clarifies that individuals are not required to follow certain utilization management processes, like prior authorization or step-therapy, if they are otherwise prohibited by law. Importantly, if applying these provisions would make an individual's health savings account (HSA) contributions ineligible, the bill specifies that the cost-sharing assistance will apply to the deductible only after the minimum deductible amount for an HSA has been met, except for preventive care services. The commissioner is tasked with creating rules and regulations to implement these changes.

Business and Industry

https://kslegislature.gov/li/b2025_26/measures/sb423/