The bill amends sections 5162.20 and 5167.12 of the Revised Code and enacts new sections 3902.65 and 5164.094 to ensure that health benefit plans and the Medicaid Program provide coverage for epinephrine and glucagon for individuals aged eighteen and younger. Specifically, it mandates that these medications be covered if deemed medically necessary by a healthcare provider. Additionally, the bill establishes a cap on cost-sharing for these medications, limiting it to sixty dollars per package for autoinjectors and sixty dollars per dose for other prescribed forms, regardless of any other cost-sharing requirements that may apply.

Furthermore, the bill includes provisions that prevent the Department of Medicaid from imposing cost-sharing requirements for epinephrine and glucagon that exceed those established for other forms of these medications. It also repeals existing sections 5162.20 and 5167.12, which are replaced by the new provisions. The intent of the bill is to improve access to critical medications for young individuals with conditions requiring epinephrine and glucagon, thereby reducing financial barriers to obtaining these essential treatments.

Statutes affected:
As Introduced: 5162.20, 5167.12