High deductible health plans; excepting certain prescription drugs from annual deductible. Effective date.
Impact
If enacted, SB1583 would make a significant change to the landscape of health insurance in Oklahoma, specifically influencing the way HDHPs are structured. By removing the deductible for specific prescription drugs used to treat serious health conditions, the legislation aims to provide relief to individuals who frequently require medication without the barrier of initial costs. This change aligns with growing perspectives on healthcare accessibility, particularly for those managing chronic illnesses, as higher expenses often lead to medication non-compliance and deteriorating health outcomes.
Summary
Senate Bill 1583, introduced by Senator Hicks, addresses high deductible health plans (HDHP) and seeks to exempt certain prescription drugs from annual deductible requirements. The bill defines chronic conditions specifically, setting parameters for what qualifies under this category, and mandates that any HDHP offered or renewed after the effective date must not impose the annual deductible for medications prescribed for these conditions. This initiative is aimed at ensuring that individuals with chronic health issues have better access to necessary medications without the burden of high out-of-pocket costs associated with their deductibles.
Contention
During discussions surrounding SB1583, various stakeholders raised points regarding its potential impact. Proponents argue that it will make necessary medications more accessible for individuals suffering from chronic conditions, thus improving overall public health. However, some insurance companies and opposition lawmakers voiced concerns about the financial implications for HDHP providers and the potential increase in premiums. Furthermore, the criteria set for what constitutes a chronic condition could lead to debates regarding fairness and adequacy of the provisions made under the bill.
High deductible health plans; directing plans to count certain self-paid claims toward an insured's deductible regardless of network status. 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.
Prescription drugs; prohibiting a health insurer from modifying coverage under certain conditions; providing exception; establishing civil penalty. Effective date.
Practice of pharmacy; requiring wholesale distributors to provide for return of certain outdated prescription drugs; requiring prompt full credit to purchaser. Effective date.
Prescription drugs; requiring certain entities to submit certain reports to the Insurance Department; directing Department to electronically publish certain information. Effective date.
Behavioral health; requiring health insurer to cover certain out-of-network services under certain circumstances; providing exceptions. Effective date.