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First Substitute S.B. 189

This document includes Senate 3rd Reading Floor Amendments incorporated into the bill on Tue, Mar 5, 2013 at 1:30 PM by lpoole. -->

Senator Curtis S. Bramble proposes the following substitute bill:


             1     
ONCOLOGY INSURANCE AMENDMENTS

             2     
2013 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Curtis S. Bramble

             5     
House Sponsor: Brad R. Wilson

             6     

             7      LONG TITLE
             8      General Description:
             9          This bill amends Part 6, Accident and Health Insurance, in Chapter 22, Contracts in
             10      Specific Lines, of the Insurance Code.
             11      Highlighted Provisions:
             12          This bill:
             13          .    defines terms; and
             14          .    provides that if a health insurer covers anticancer medication, the insurer may not
             15      exceed certain cost sharing limits.
             16      Money Appropriated in this Bill:
             17          None
             18      Other Special Clauses:
             19          None
             20      Utah Code Sections Affected:
             21      ENACTS:
             22          31A-22-641, Utah Code Annotated 1953
             23     

             24      Be it enacted by the Legislature of the state of Utah:
             25          Section 1. Section 31A-22-641 is enacted to read:



Text Box

- 2 -
Senate 3rd Reading Amendments 3-5-2013 lp/cjd
             26          31A-22-641. Cancer treatment parity.
             27          (1) For purposes of this section:
             28          (a) "Anticancer medication" means prescribed, self administered anticancer medication
             29      that is used to kill or slow the growth of cancerous cells.
             30          (b) "Cost sharing" includes copayments, deductibles, coinsurance, and other dollar
             31      limits.
             32          (c) "Health insurer" is as defined in Subsection 31A-22-634 (1).
             33          (2) This section applies to health benefit plans renewed or entered into on or after S. [ July
             34      1, 2013
] October 1, 2013 .S
.
             35          (3) A health benefit plan that covers anticancer medication:
             36          (a) shall not impose a copayment or coinsurance that exceeds S. [ $250 ] $300 .S a month
             36a      for the
             37      anticancer medication; and
             38          (b) shall apply any monthly out-of-pocket costs for the anticancer medication that is
             39      paid by the individual to any deductibles or maximum out-of-pocket costs imposed by the
             40      health benefit plan.
             41          (4) (a) A health insurer shall not increase the cost sharing for anticancer medication or
             42      other physician prescribed cancer treatment, however administered, for the purpose of
             43      achieving compliance with this section.
             44          (b) The commissioner may adopt administrative rules in accordance with Title 63G,
             45      Chapter 3, Utah Administrative Rulemaking Act, to enforce the provisions of this section.


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