Health insurance; diabetes plan requirements; effective date.
Impact
One of the notable changes introduced by HB3979 is the establishment of a cost-sharing cap for insulin. The bill caps the amount that patients have to pay for insulin at a maximum of $30 for a thirty-day supply and $90 for a ninety-day supply, which aims to alleviate the financial burden on individuals managing diabetes. This provision is significant, as insulin costs can be prohibitive for many patients, contributing to uncontrolled diabetes and related health complications.
Summary
House Bill 3979 seeks to amend Oklahoma's health insurance laws concerning diabetes treatment. The bill mandates that every health benefit plan must provide coverage for all medically necessary equipment, supplies, and services for the treatment of Type I, Type II, and gestational diabetes. This includes essential items like blood glucose monitors, insulin, syringes, and diabetes self-management training. Additionally, health insurance carriers are required to develop and update a list of approved diabetes-related items in consultation with relevant health professionals and organizations.
Contention
While the intent of the bill is aimed at improving access to necessary diabetes care, there may be concerns regarding its implementation and the financial implications for insurance carriers. Critics may argue that the established caps could lead to increased premiums or reduced coverage quality in other areas. Furthermore, there may be points of debate around the extent to which this legislation affects local regulations or existing benefit plans that were previously set up.
Enforcement
The bill entrusts the enforcement of its provisions to both the Insurance Department and the State Department of Health, ensuring compliance with the new requirements. This dual oversight aims to provide a balanced approach to monitoring health insurers and maintaining the quality and availability of diabetes care under state law.
Health insurance; definitions; treatment of diabetes; Insurance Department and the State Department of Health to purchase insulin at discounted prices; program that allows Oklahomans to purchase discounted insulin; codification; effective date.
Health insurance; definitions; treatment of diabetes; Insurance Department and the State Department of Health to purchase insulin at discounted prices; program that allows Oklahomans to purchase discounted insulin; codification; effective date.
Health insurance; modifying copayment cap of certain insulin supply; requiring copayment cap for certain diabetes equipment and supplies; requiring reduction in cost-sharing amount for certain supply and equipment. Effective date.
Health insurance; modifying copayment cap of certain insulin supply; requiring copayment cap for certain diabetes equipment and supplies; requiring reduction in cost-sharing amount for certain supply and equipment. Effective date.
Health insurance; requiring certain high deductible health plans to allow an insured to set aside funds for medical expenses subject to certain limitations. Effective date.