Medicare may plan to negotiate drug prices, but some states are taking their own steps to lower costs
The bill requires the division of insurance in the department of regulatory agencies (division) to create an application for the program and requires the division and the department of health care policy and financing to make the application available on their websites and to promote the availability of the program. The bill requires a carrier that provides coverage for prescription epinephrine auto-injectors to cap the total amount that a covered person is required to pay for all covered prescription epinephrine auto-injectors at an amount not to exceed $60 for a 2-pack of epinephrine auto-injectors. [...]
Concerning extending continuous eligibility medical coverage for certain individuals, and, in connection therewith, seeking federal authorization and making an appropriation. The bill requires the department of health care policy and financing (state department) to conduct a study to determine the feasibility of extending continuous eligibility medical coverage for eligible children and adults.
For health benefit plans issued or renewed on or after January 1, 2025, the bill requires a health insurer or pharmacy benefit manager to include in the calculation of a covered person's contributions toward cost-sharing requirements, including any annual limitation on a covered person's out-of-pocket costs, any payments made by or on behalf of the covered person for a prescription drug if: The prescription drug does not have a generic equivalent; or The prescription drug has a generic equivalent but the covered person is using the brand-name drug after obtaining prior authorization, complying with [...]
Increase Consumer Protections Medical Transactions. Concerning increasing consumer protections in various medical transactions. Makes it a deceptive trade practice to violate provisions relating to billing practices, surprise billing, and balance billing laws; and requires a health-care provider or health-care facility to provide, upon request of a prospective patient, an estimate of the total cost of a health-care service (service) to a person who intends to self-pay for the service (self-pay estimate). The bill includes requirements for the self-pay estimate and caps the amount by which the final, total cost of the service may exceed [...]