An Act Limiting Changes To Health Insurers' Prescription Drug Formularies.
Impact
If enacted, HB 06622 would amend existing insurance statutes, thereby enhancing consumer protections regarding outpatient prescription drugs. It delineates clear conditions under which drugs may be removed from coverage, ensuring that these decisions are rooted in safety and efficacy rather than cost-saving or profit-maximizing motives by insurers. By stabilizing the drug formulary landscape, the bill seeks to foster greater transparency and predictability for policyholders.
Summary
House Bill 06622 aims to limit health insurers' ability to change their prescription drug formularies during the policy term. Specifically, the bill prohibits insurers from removing covered prescription drugs from their formularies or reclassifying them to higher cost-sharing tiers, unless the drug is deemed unsafe or ineffective based on FDA guidelines or recognized peer-reviewed medical literature. This measure is introduced to protect consumers from sudden changes that could affect their access to necessary medications and associated costs.
Contention
Debate around HB 06622 centers on the balance between regulating insurance practices and allowing insurers the flexibility to manage their cost structures responsibly. Supporters argue that the bill enhances the consumer's right to access necessary medications without unexpected out-of-pocket expenses. Critics may highlight concerns over the potential for increased costs to insurers, which could, in turn, lead to higher premiums for policyholders. The conversation likely engages broader themes of healthcare affordability and insurance industry profitability.
An Act Prohibiting Certain Health Carriers From Requiring Step Therapy For Prescription Drugs Used To Treat A Mental Or Behavioral Health Condition Or A Chronic, Disabling Or Life-threatening Condition.