RDCSB282 1814 3595
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
SB 282 Reengrossed 2018 Regular Session Mills
Proposed law requires certain health insurance issuers to notify enrollees and prospective
enrollees that they may be subject to an excess consumer cost burden when an enrollee is
charged more for a prescription drug than his issuer pays or would pay after accounting for
the issuer's estimate of at least 50% of future rebate payments for the enrollee's actual point
of sale prescription drug claim.
Proposed law requires certain health insurance issuers to annually make available to the
commissioner of insurance information regarding the value of rebates expressed as a
percentage that the health insurance issuer made available to enrollees at the point of sale.
Proposed law prohibits a health insurance issuer from publishing or otherwise revealing
information regarding the actual amount of rebates the health insurance issuer receives,
including but not limited to information regarding the amount of rebates it receives on a
product, manufacturer, or pharmacy specific basis. Provides that such information is a trade
secret, is not a public record as defined under present law (Public Records Law) and shall
not be disclosed directly or indirectly. Requires a health insurance issuer to impose the
confidentiality protections of proposed law on any third parties or vendors with which it
contracts that may receive or have access to rebate information.
Proposed law applies to health insurance issuers that offer or renew health benefit plans for
sale in the state on or after Jan. 1, 2020.
(Amends R.S. 44:4.1(B)(11); Adds R.S. 22:976)
Summary of Amendments Adopted by Senate
Senate Floor Amendments to engrossed bill
1. Removes provision applying proposed law to pharmacy benefit managers
participating in the Medicaid program.
2. Makes a technical change.
3. Changes definition of "excess consumer cost burden".
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
reengrossed bill:
1. Make technical changes.
The Committee Amendments Proposed by House Committee on House and
Governmental Affairs to the reengrossed bill:
1. Provide that an issuer's estimate of at least 50% of future rebate payments for the
enrollee's actual point of sale prescription drug claim is accounted for in
determining excess consumer cost burden instead of accounting for rebates or a
prorated amount of the issuer cost based on the enrollee's coinsurance amount.
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2. Exempt the Office of Group Benefits from the proposed law definition of "health
insurance issuer".
3. Provide that price concessions that accrue to the health insurance issuer and fees
and administrative costs passed through to the issuer are included in the proposed
law definition of rebates only if such concessions, fees, or costs are the result of
point of sale prescription drug claim processing.
4. Change the date on or after which a health insurance issuer must offer or renew
health benefit plans for sale in the state for proposed law to apply to the issuer
from Jan. 1, 2019, to Jan. 1, 2020.
5. Remove proposed law provisions that require a health insurance issuer to
annually certify to the commissioner of insurance that, during the prior benefit
year, the health insurance issuer made available to enrollees at the point of sale
at least an amount greater than 50% of rebates received by the insurer.
6. Add provisions that require a health insurance issuer to annually make available
to the commissioner of insurance information regarding the value of rebates
expressed as a percentage that the health insurance issuer made available to
enrollees at the point of sale.
7. Remove proposed law provisions that authorize the commissioner of insurance
to enforce proposed law.
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