After passing the Senate earlier this week, discussion on a bill (SB 300) took place in the Assembly that would require an insurance plan that covers both intravenous and oral chemotherapy to treat the cost-sharing (copayment, deductible or coinsurance amounts) for oral chemotherapy the same as cost sharing for intravenous treatments. Referred to as “parity” the bill requires insurers to modify benefit design to achieve parity between the medical benefit design of the plan, which applies to injected or intravenous chemotherapy, and the pharmaceutical benefit design, which typically applies to oral chemotherapy drugs.
On Thursday, the Assembly concurred in the bill as amended by Assembly Amendment 1 to SB 300. The amendment provides that an insurance plan that covers both intravenous chemotherapy and oral chemotherapy must either offer cost-sharing parity or establish a drug copayment of no more than $100 for a 30-day supply of oral chemotherapy drugs.
The amendment also clarifies that in the case of a qualified high deductible plan (Health Savings Account – HSA plan) the special treatment for oral chemotherapy does not apply until the insured has met his or her deductible for the year under such a plan.
The bill, as amended, has been sent back to the Senate where it is expected to be taken up on April 1st.