Bill > H984

This bill establishes a program within the Executive Office of Health and Human Services to eliminate copayments, coinsurance, and deductibles—which are all forms of "cost sharing" or payments a consumer makes for healthcare—for certain prescription drugs and medical and behavioral health services deemed "high-value cost-effective." To determine which services qualify, the Secretary of Health and Human Services will establish a Barrier-Free Care Expert Panel, composed of various healthcare professionals and experts, to make recommendations. This panel will consider services that are outpatient, evidence-based, likely to prevent more serious health issues, relatively inexpensive compared to the cost of prevented illness, and at low risk for misuse. The bill also mandates that insurance plans, health coverage, and medical assistance programs, including those for state employees and retirees, must waive cost sharing for these identified services, with an exception if doing so would jeopardize a plan's tax-exempt status under federal law. Furthermore, the bill requires an evaluation every two years to assess the impact of these changes on treatment adherence, health outcomes, and costs.