| 1 | 1 | | FIRSTREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.1195 |
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| 3 | 3 | | 103RDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEPOUCHE. |
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| 5 | 5 | | 2629H.01I JOSEPHENGLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Toamendchapter376,RSMo,byaddingtheretotwonewsectionsrelatingtothecostof |
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| 8 | 8 | | prescriptions. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Chapter376,RSMo,isamendedbyaddingtheretotwonewsections,tobe |
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| 11 | 11 | | 2knownassections376.687and376.689,toreadasfollows: |
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| 12 | 12 | | 376.687.1.Asusedinthissection,thefollowingtermsmean: |
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| 13 | 13 | | 2 (1)"Epinephrineauto-injector",aprescribed,single-usedeviceusedforthe |
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| 14 | 14 | | 3automaticinjectionofapremeasureddoseofepinephrineintothehumanbody; |
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| 15 | 15 | | 4 (2)"Prescriptioninsulindrug",aprescriptiondrugthatcontainsinsulinandis |
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| 16 | 16 | | 5usedtocontrolbloodglucoselevelstotreatdiabetesbutdoesnotincludeaninsulindrug |
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| 17 | 17 | | 6thatisadministeredtoapatientintravenously. |
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| 18 | 18 | | 7 2.Thissectionappliestoanygrouporindividualpolicyofaccidentandhealth |
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| 19 | 19 | | 8insuranceamended,delivered,issued,orrenewedonorafterAugust28,2025. |
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| 20 | 20 | | 9 3.(1)Aninsurerthatprovidescoverageforprescriptioninsulindrugsunderthe |
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| 21 | 21 | | 10termsofahealthcoverageplantheinsureroffersshalllimitthetotalamountthatan |
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| 22 | 22 | | 11insuredisrequiredtopayforathirty-daysupplyofcoveredprescriptioninsulindrugs |
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| 23 | 23 | | 12atanamountnottoexceedthirty-fivedollars,regardlessofthequantityortypeof |
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| 24 | 24 | | 13coveredprescriptioninsulindrugusedtofilltheinsured'sprescription. |
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| 25 | 25 | | 14 (2)Aninsurerthatprovidescoverageforepinephrineauto-injectorsunderthe |
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| 26 | 26 | | 15termsofahealthcoverageplantheinsureroffersshalllimitthetotalamountthatan |
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| 27 | 27 | | 16insuredisrequiredtopayforathirty-daysupplyofcoveredepinephrineauto-injectors |
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| 28 | 28 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 29 | 29 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17atanamountnottoexceedonehundreddollars,regardlessofthequantityortypeof |
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| 30 | 30 | | 18coveredepinephrineauto-injectorusedtofilltheinsured'sprescription. |
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| 31 | 31 | | 19 4.OnJanuaryfirstofeachyear,thelimitontheamountthataninsuredis |
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| 32 | 32 | | 20requiredtopayforathirty-daysupplyofacoveredprescriptioninsulindrugor |
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| 33 | 33 | | 21epinephrineauto-injectorshallincreasebyapercentageequaltothepercentagechange |
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| 34 | 34 | | 22fromtheprecedingyearinthemedicalcarecomponentoftheConsumerPriceIndexof |
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| 35 | 35 | | 23theBureauofLaborStatisticsoftheUnitedStatesDepartmentofLabor. |
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| 36 | 36 | | 24 5.If,underfederallaw,applicationofanyrequirementunderthissectionwould |
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| 37 | 37 | | 25resultinhealthsavingsaccountineligibilityunderSection223oftheInternalRevenue |
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| 38 | 38 | | 26Codeof1986,asamended,therequirementsofthissectionshallapplytohealthsavings |
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| 39 | 39 | | 27account-qualifiedhighdeductiblehealthplanswithrespecttoanycost-sharingofsucha |
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| 40 | 40 | | 28planaftertheenrolleehassatisfiedtheminimumdeductibleunderSection223,except |
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| 41 | 41 | | 29withrespecttoitemsorservicesthatarepreventivecareunderSection223(c)(2)(C)of |
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| 42 | 42 | | 30theInternalRevenueCodeof1986,asamended,inwhichcasetherequirementsofthis |
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| 43 | 43 | | 31sectionshallapplyregardlessofwhethertheminimumdeductibleunderSection223has |
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| 44 | 44 | | 32beensatisfied. |
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| 45 | 45 | | 33 6.Thedirectorofthedepartmentofcommerceandinsurancemaypromulgate |
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| 46 | 46 | | 34allnecessaryrulesandregulationsfortheadministrationofthissection.Anyruleor |
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| 47 | 47 | | 35portionofarule,asthattermisdefinedinsection536.010,thatiscreatedunderthe |
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| 48 | 48 | | 36authoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandis |
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| 49 | 49 | | 37subjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.This |
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| 50 | 50 | | 38sectionandchapter536arenonseverableandifanyofthepowersvestedwiththe |
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| 51 | 51 | | 39generalassemblypursuanttochapter536toreview,todelaytheeffectivedate,orto |
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| 52 | 52 | | 40disapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof |
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| 53 | 53 | | 41rulemakingauthorityandanyruleproposedoradoptedafterAugust28,2025,shallbe |
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| 54 | 54 | | 42invalidandvoid. |
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| 55 | 55 | | 376.689.1.BeforeNovember1,2025,thedepartmentofcommerceand |
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| 56 | 56 | | 2insurance,inconjunctionwiththedepartmentofhealthandseniorservicesandthe |
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| 57 | 57 | | 3departmentofsocialservices,shallmakeavailabletothepublicareportthatdetails |
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| 58 | 58 | | 4eachdepartment'sfindingsforthefollowing: |
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| 59 | 59 | | 5 (1)Asummaryofinsulinpricingpracticesandepinephrineauto-injectorpricing |
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| 60 | 60 | | 6practicesandvariablesthatcontributetothepricingofhealthcoverageplans; |
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| 61 | 61 | | 7 (2)Publicpolicyrecommendationstocontrolandpreventoverpricingof |
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| 62 | 62 | | 8prescriptioninsulindrugsandepinephrineauto-injectorsmadeavailabletoMissouri |
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| 63 | 63 | | 9consumers;and |
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| 64 | 64 | | 10 (3)Anyotherinformationthatthedepartmentofcommerceandinsurancefinds |
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| 65 | 65 | | 11necessary. |
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| 66 | 66 | | HB1195 2 12 2.TheprovisionsofthissectionterminateonJanuary1,2026. |
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| 67 | 67 | | âś” |
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| 68 | 68 | | HB1195 3 |
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