Bill > SB1199

This bill requires health care service plans and health insurers to count any financial assistance provided by drug manufacturers directly to patients, such as discounts or vouchers, towards the patient's out-of-pocket maximum and cost-sharing requirements, which are limits on how much an individual has to pay for covered medical services and prescription drugs. This means that if a drug manufacturer helps pay for a prescription, that amount will count towards the patient's annual limit on what they have to pay, potentially helping them reach that limit faster. The bill also establishes penalties for health insurers who violate these provisions, including administrative penalties of up to $5,000 per violation, or up to $10,000 for willful violations. This change aims to ensure that patients benefit from manufacturer assistance in meeting their cost-sharing obligations.

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB1199