AB 1803 – California
Introduced: 2019 Status: Enacted
Pharmacy: healthcare coverage: claims for prescription drugs sold for retail price – Existing law, the Pharmacy Law, requires a pharmacy to inform a customer at the point of sale for a covered prescription drug whether …
AB 2352 – California
Introduced: 2022 Status: Enacted
Prescription drug coverage. This bill would require a health care service plan or health insurer that provides prescription drug benefits and maintains one or more drug formularies to furnish specified information about a prescription drug …
AB 2863 – California
Introduced: 2018 Status: Enacted Year Enacted: 2018
HEALTH CARE COVERAGE – PRESCRIPTIONS: This bill would limit the amount a health care service plan, health insurer, or pharmacy benefit manager may require an enrollee or insured to pay at the point of sale …
AB 7 (see companion bill SB 3) – Wisconsin
Introduced: 2021 Status: Inactive / Dead
An Act relating to: licensure of pharmacy benefit managers, pharmacy benefit manager regulation, disclosures to consumers; cost-sharing limitation, drug substitution. Under the bill, a health insurance policy or a governmental self-insured health plan may not, …
AB 705 – California
Introduced: 2021 Status: Inactive / Dead
Health care: facilities: medical privileges. (1) Existing law prohibits health care service plans and their contracting entities from including provisions in their contracts that interfere with the ability of a physician and surgeon or other …
AB 752 – California
Introduced: 2021 Status: Inactive / Dead
Prescription drug coverage. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a …
AB 800 (see companion bill SB 669) – Wisconsin
Introduced: 2017 Status: Inactive / Dead
This bill prohibits a health insurance policy, referred to in the statutes as a disability insurance policy, or a governmental self-insured health plan from including in a contract for pharmacy services, or allowing a pharmacy …
Ala. Code § 22-6-124. Confidentiality of information: Medicaid Preferred Drug Plan – Alabama
Status: Enacted Year Enacted: 2003
Records in the State Medicaid Agency related to trade secrets, proprietary information, rebate amounts, and manufacturer pricing shall be confidential and shall not be a public record for purposes of Ala. Code § 41-3-1 (1975).
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Ariz. Rev. Stat. § 32-3221. Lawful health care services; patient education; exceptions; definitions: Health Professionals – General Provisions – Arizona
Status: Enacted Year Enacted: 2016
Unless an entity has a sincerely held religious or moral belief, the entity may not restrict a health professional who is an employee of or affiliated or contracted with the entity for making a patient …
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Ariz. Rev. Stat. §§ 44-1751 through 44-1754: Regulations Concerning Particular Businesses — Pharmacy Benefit Managers – Arizona
Status: Enacted Year Enacted: 2018
Provides regulation of pharmacy benefit managers, such as they may not prohibit a pharmacist or pharmacy from providing an insured individual information on the amount of the insured’s cost share for the insured’s prescription drug …
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Ark. Code § 23-99-407. “Gag clause” prohibition: Arkansas Health Care Consumer Act – Arkansas
Status: Enacted Year Enacted: 1997
No participating provider may be prohibited, restricted, or penalized in any way from disclosing to any covered person any healthcare information that the participating provider deems appropriate regarding the nature of treatment, risks, or alternatives …
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Ark. Code §§ 23-99-401 through 23-99-416: Healthcare Providers — Arkansas Health Care Consumer Act – Arkansas
Status: Enacted Year Enacted: 1997
As the state’s insurance sector becomes increasingly dominated by managed care features that include decisions regarding coverage and appropriateness of health care, there is a vital need to protect patients in this environment.
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Cal. Health & Safety Code § 1367.49. Ability of health care service plan to furnish information to consumers or purchasers concerning cost range of procedures or quality of services; contractual provisions; statement posted on Internet Web site: Knox-Keene Health Care Service Plan Act of 1975 – California
Status: Enacted Year Enacted: 2011
Prohibits gag clauses preventing the disclosure to patients and enrollees of the quality of the services and a cost range of a procedure or a full course of treatment (including facility, professional and diagnostic fees).
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Cal. Health & Safety Code § 1367.50. Disclosure of claims data to enrollee or subscriber not to be restricted by contract between plan and provider or supplier; application of federal law; definitions: Knox-Keene Health Care Service Plan Act of 1975 – California
Status: Enacted Year Enacted: 2012
Prohibits gag clauses preventing the disclosure to qualified entities of all claims data for health care services supplied to enrollee or beneficiary of a service plan or self-funded health coverage arrangement administered by a service …
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Cal. Ins. Code §§ 10133 through 10133.11: Life and Disability Insurance — Transfer – California
Status: Enacted Year Enacted: 1951
Nothing in this section shall be construed to authorize an insurer to furnish or directly provide services of hospitals, or psychiatric health facilities, as defined in Section 1250.2 of the Health and Safety Code, or …
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Conn. Gen. Stat. § 38a-477f. Contract provisions prohibiting certain disclosures prohibited: Health Insurance: In General – Connecticut
Status: Enacted Year Enacted: 2015
Prohibits contracts entered into after Jan 2016 from containing provisions that prohibit the disclosure of billed or allowed amounts, reimbursement rates or out of pocket costs and any data to the all-payer claims database program.
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