House Bill No. by Representative Freeman aims to enhance health insurance coverage for orally administered anti-cancer medications by establishing guidelines that ensure parity with intravenously administered or injected anti-cancer medications. The bill amends R.S. 22:999.1 to declare that individuals with health coverage plans for cancer treatment must have access to prescribed oral medications, which are often more cost-prohibitive. It prohibits health insurance issuers from imposing any cost-sharing, utilization management, or copayment adjustments that would result in higher out-of-pocket expenses for these oral medications compared to their intravenous counterparts.

The proposed law also mandates that cost-sharing for orally administered anti-cancer medications be applied towards the enrollee's deductible and annual out-of-pocket maximum in the same way as other covered benefits. Additionally, it prohibits health insurance issuers from reclassifying or increasing cost-sharing for anti-cancer medications to comply with these requirements. The bill expands the applicability of these provisions to various health coverage plans, including individual and group plans, high-deductible health plans, and nonfederal governmental plans, while ensuring that self-funded employee benefit plans governed by ERISA are not regulated beyond federal law limits.

Statutes affected:
HB766 Original: