Bill Number: S.B. 1216

                                                                                                                  Leff Floor Amendment

                                                                                         Reference to: HEALTH amendment

                                Amendment drafted by: Legislative Council – Michele Hanigsberg

 

 

 

• Limits the amount health insurers may charge for orally administered anticancer medication to 400 percent of a contract’s Tier III prescription drug copayment.

 

• Applies the limitation specifically to health insurers that provide coverage for both cancer chemotherapy treatment administered intravenously and anticancer medication administered orally, if the health insurer imposes coinsurance for the orally administered anticancer medication.

 

• Continues to allow health insurers to require prior authorization, develop a formulary or impose other utilization controls in approving coverage for chemotherapy.

 

• Continues to apply the provisions of the bill to orally administered anticancer medication that is specifically used to kill or slow the growth of cancerous cells.

 

• Makes technical changes.

Forty-ninth Legislature                                                      Leff

Second Regular Session                                                  S.B. 1216

LEFF FLOOR AMENDMENT

SENATE AMENDMENTS TO S.B. 1216

(Reference to HEALTHCARE AND MEDICAL LIABILITY REFORM amendment)

 

Page 1, line 1, before "offered" insert "that is"

Strike lines 2, 3 and 4, insert:

Strike lines 8 through 14, insert "and that imposes coinsurance for orally administered anticancer medication shall not charge more than four hundred per cent of the contract's tier three prescription drug copayment for orally administered anticancer medication."

Line 6, strike "nothing in"; after "shall" insert "not"

Line 9, after the period, insert "C."

Line 11, before "offered" insert "that is"

Strike lines 12 through 15, insert:

Line 21, after "cells" strike remainder of line

Strike lines 22 through 28, insert "and that imposes coinsurance for orally administered anticancer medication shall not charge more than four hundred per cent of the contract's or evidence of coverage's tier three prescription drug copayment for orally administered anticancer medication."

Line 17, strike "nothing in"; after "shall" insert "not"

Line 20, after the period, insert "C."

Line 22, before "offered" insert "that is"

Strike lines 23 through 26, insert:

Line 35, after "cells" strike remainder of line

Strike lines 36 through 41, insert "and that imposes coinsurance for orally administered anticancer medication shall not charge more than four hundred per cent of the policy's tier three prescription drug copayment for orally administered anticancer medication."

Page 2, line 1, strike "nothing in"; after "shall" insert "not"

Line 4, after the period, insert "C."

Line 6, before "offered" insert "that is"

Strike lines 7 through 11, insert:

Line 7, after "cells" strike remainder of line

Strike lines 8 through 14, insert "and that imposes coinsurance for orally administered anticancer medication shall not charge more than four hundred per cent of the group disability policy's tier three prescription drug copayment for orally administered anticancer medication."

Page 2, line 16, after the period, insert "C."

Line 18, before "offered" insert "that is"

Strike lines 19 through 23, insert:

Line 19, after "cells" strike remainder of line

Strike lines 20 through 26, insert "and that imposes coinsurance for orally administered anticancer medication shall not charge more than four hundred per cent of the policy's or contract's tier three prescription drug copayment for orally administered anticancer medication."

Line 25, strike "nothing in"; after "shall" insert "not"

Line 28, after the period, insert "C."

Line 30, before "offered" insert "that is"

Strike lines 31 and 32

Page 3, strike lines 1, 2 and 3, insert:

Page 2, line 33, after "cells" strike remainder of line

Strike lines 34 through 40, insert "and that imposes coinsurance for orally administered anticancer medication shall not charge more than four hundred per cent of the health benefit plan's tier three prescription drug copayment for orally administered anticancer medication."

Line 5, strike "nothing in"; after "shall" insert "not"

Line 8, after the period, insert "C."

Strike line 10, insert:

Page 2, line 43, strike "December 31" insert "September 30"

Amend title to conform

 

 

1216bl3

03/24/2010

5:02 PM

C: mjh