Iowa 2023-2024 Regular Session

Iowa Senate Bill SSB1009

Introduced
1/10/23  
Introduced
1/10/23  

Caption

A bill for an act relating to insurance coverage for prescription drugs used in the treatment of metastatic cancer and associated conditions.

Impact

One of the significant impacts of SSB1009 is that it requires health insurance providers to eliminate 'step therapy protocols' when it comes to the prescription cancer drugs covered. Step therapy often requires patients to try less expensive medications before moving onto costlier options, which can delay critical treatments for metastatic cancer patients. By mandating the immediate coverage of these drugs, the bill aims to streamline patient access to necessary medical treatments, potentially improving health outcomes for those battling advanced stages of cancer.

Summary

Senate Study Bill 1009 aims to enhance insurance coverage for prescription drugs specifically for the treatment of metastatic cancer and associated conditions. The bill mandates that any health insurance policy providing coverage for prescription drugs must also cover prescription cancer drugs. It outlines specific definitions around terms such as 'metastatic cancer', 'associated conditions', and 'covered persons', ensuring clarity in the legislation's application. The bill underscores that treatment options must adhere to medical standards and be backed by peer-reviewed literature, thereby emphasizing a data-driven approach to treatment coverage.

Contention

Notable points of contention surrounding SSB1009 may include discussions about cost implications for insurance providers and the potential for increased insurance premiums due to expanded coverage requirements. Critics might argue that eliminating step therapy could lead to higher expenditures on more expensive cancer drugs. In contrast, supporters of the bill stress the urgency of timely access to medically necessary treatments for cancer patients, highlighting the importance of quality of life and survival rates.

Overall_significance

This bill reflects a growing awareness and response to the needs of patients suffering from serious health conditions, particularly cancer. By legislating a more inclusive health insurance coverage policy for critical treatments, SSB1009 signifies a potential shift in how state laws address healthcare accessibility, particularly concerning life-threatening conditions. Future discussions may revolve around the practicality of implementation and the balance between coverage costs and patient welfare.

Companion Bills

IA HF57

Replaced by A bill for an act relating to insurance coverage for prescription drugs used in the treatment of metastatic cancer and associated conditions.

Similar Bills

TN SB1382

AN ACT to amend Tennessee Code Annotated, Title 8; Title 56; Title 63; Title 68 and Title 71, relative to step therapy.

IA HF57

A bill for an act relating to insurance coverage for prescription drugs used in the treatment of metastatic cancer and associated conditions.

IA SF197

A bill for an act relating to insurance coverage for prescription drugs used in the treatment of metastatic cancer and associated conditions.

TN HB0858

AN ACT to amend Tennessee Code Annotated, Title 8; Title 56; Title 63; Title 68 and Title 71, relative to step therapy.

IN HB1062

Coverage for certain cancer prescriptions.

MD HB1087

Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer

LA HB370

Provides relative to prescription drug benefits for persons with stage-four advanced, metastatic cancer (EN SEE FISC NOTE SG EX See Note)

ND SB2248

Step therapy protocols; to provide for a report to the legislative assembly; to provide for application; and to provide an expiration date.