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