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3 Councilmember Mary M. Cheh
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9 A BILL
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14 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
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19 To amend the Specialty Drug Copayment Limitation Act to impose a limit on the amount that a
20 person must pay in copayment or coinsurance through a health benefit plan for a
21 prescription for insulin.
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23 BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
24 act may be cited as the Insulin Affordability Amendment Act of 2020.
25 Sec. 2. The Specialty Drug Copayment Limitation Act, effective April 7, 2017 (D.C. Law
26 21-248; D.C. Official Code 48-855.01 et seq.), is amended as follows:
27 (a) Section 2 (D.C. Official Code 48-855.01) is amended by adding a new paragraph
28 (9A) to read as follows:
29 (9A) Prescription insulin drug means a prescription drug that contains insulin
30 and is used to control blood glucose levels to treat diabetes..
31 (b) Section 4 (D.C. Official Code 48-855.03) is amended by striking the phrase
32 January 1, 2018 and inserting the phrase January 1, 2018; provided that section 5 of this act
33 shall apply on or after January 1, 2022. in its place.
34 (c) A new section 5 (D.C. Official Code 48-855.04) is added to read as follows:
35 Sec. 5. Insulin copayment or coinsurance limitation.
36 (a) A health insurer that provides coverage for prescription insulin drugs
37 pursuant to the terms of a health benefits plan the insurer offers shall limit the total amount that
38 an insured is required to pay for a 30-day supply of covered prescription insulin drugs at an
39 amount not to exceed $30, regardless of the quantity or type of covered prescription insulin drug
40 used to fill the insureds prescription.
41 (b) Nothing in this section prevents an insurer from reducing an insureds
42 copayment or coinsurance by an amount greater than the amount specified in subsection (a).
43 (c) On July 1 of each year, the limit on a required copayment or coinsurance an
44 insured is required to pay for a 30-day supply of a covered prescription insulin drug shall
45 increase by a percentage equal to the percentage change from the preceding year in the medical
46 care component of the Consumer Price Index for All Urban Consumers, Washington-Baltimore
47 metropolitan area, as published by the Bureau of Labor Statistics of the United States
48 Department of Labor..
49 Sec. 3. Fiscal impact statement.
50 The Council adopts the fiscal impact statement in the committee report as the fiscal
51 impact statement required by section 4a of the General Legislative Procedures Act of 1975,
52 approved October 16, 2006 (120 Stat. 2038; D.C. Official Code 1-301.47a).
53 Sec. 4. Effective date.
54 This act shall take effect following approval by the Mayor (or in the event of veto by the
55 Mayor, action by the Council to override the veto), a 30-day period of congressional review as
56 provided in section 602(c)(l) of the District of Columbia Home Rule Act, approved December
57 24, 1973 (87 Stat. 813; D.C. Official Code 1-206.02(c)(l)), and publication in the District of
58 Columbia Register.