SP0217
LD 627
Session - 126th Maine Legislature
C "B", Filing Number S-379, Sponsored by
LR 1498
Item 6
Bill Tracking, Additional Documents Chamber Status

Amend the bill by striking out everything after the enacting clause and before the summary and inserting the following:

Sec. 1. 24-A MRSA §4317-B  is enacted to read:

§ 4317-B Orally administered cancer therapy

1 Coverage.   A carrier that provides coverage for cancer chemotherapy treatment shall provide coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells that is equivalent to the coverage provided for intravenously administered or injected anticancer medications. An increase in patient cost sharing for anticancer medications may not be used to achieve compliance with this section.
2 Construction.   This section may not be construed to prohibit or limit a carrier's ability to establish a prescription drug formulary or to require a carrier to cover an orally administered anticancer medication on the sole basis that it is an alternative to an intravenously administered or injected anticancer medication.

Sec. 2. Application. This Act applies to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2015. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.’

summary

This amendment replaces the bill and requires health insurance carriers that provide coverage for cancer chemotherapy to include coverage for orally administered anticancer medications that is equivalent to the coverage provided for intravenously administered or injected anticancer medications. The requirement applies to all policies, contracts and certificates issued or renewed on or after January 1, 2015.

The amendment also clarifies that the provision does not limit a carrier's ability to establish a prescription drug formulary and does not require a carrier to cover an orally administered anticancer medication simply because it is an alternative to an intravenously administered or injected anticancer medication.

FISCAL NOTE REQUIRED
(See attached)


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