Section 21.42.430. Coverage for anti-cancer medication.

   (a) Except for a fraternal benefit society, a health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan that provides coverage for anti-cancer medications that are injected or intravenously administered by a health care provider and patient-administered anti-cancer medications, including those orally administered or self-injected, may not require a higher copayment, deductible, or coinsurance amount for a patient-administered medication than it requires for an anti-cancer medication injected or intravenously administered by a health care provider, regardless of the formulation or benefit category determination by the policy or plan.
   (b) A health care insurer may not offset the costs of compliance with (a) of this section by
        (1) increasing the copayment, deductible, or coinsurance amount required for anti-cancer medications injected or intravenously administered by a health care provider that are covered under the health insurance plan; or
        (2) reclassifying benefits with respect to anti-cancer medications.
   (c) Nothing in this section prohibits a health care insurance plan from requiring different cost-sharing rates for in-network and out-of-network providers or pharmacies.
   (d) In this section, "anti-cancer medication" means a drug or biologic used to kill cancerous cells, to slow or prevent the growth of cancerous cells, or to treat related side effects.

Notes

History

(Sec. 1 ch 34 SLA 2016)