Missouri Senate Bill SB844

Missouri 2024 Regular Session

• Introduced: 1/3/24
• Refer: 1/11/24

Caption

Requires any amount paid on behalf of a health benefit plan enrollee to count toward the enrollee's cost-sharing

Impact

By mandating that all costs paid on behalf of an enrollee count towards their cost-sharing requirements, SB844 has the potential to alter the financial dynamics for patients utilizing specific medications. This could lead to a more equitable system where individuals do not face financial barriers based on the availability of generic alternatives. Additionally, this bill may influence how health carriers and pharmacy benefit managers structure their plans and reimbursement models, ensuring they remain compliant with the new regulations.

Summary

Senate Bill 844 aims to amend existing statutes related to health benefit plans, specifically by introducing provisions regarding the calculation of cost-sharing for enrollees. The new section added to chapter 376 of the Revised Statutes of Missouri defines cost-sharing and establishes how contributions to out-of-pocket maximums should include amounts paid for medications without a generic alternative. This change seeks to enhance the financial transparency for enrollees concerning their healthcare expenses and provide a clearer understanding of their contributions towards healthcare costs.

Contention

Notable points of contention regarding SB844 may arise from the perspectives of health carriers and pharmacy benefits managers, who could view the new requirement as an added burden to their existing processes. Opponents might argue that while the bill aims to protect enrollees, it might inadvertently lead to increased healthcare costs if providers pass on the costs of compliance to consumers. Stakeholders in the healthcare system may have differing views on the best approaches to manage costs and coverage, which could fuel ongoing debates about healthcare reform in Missouri.