HB 265: "An Act relating to insurance coverage for pharmacy services."
00 HOUSE BILL NO. 265 01 "An Act relating to insurance coverage for pharmacy services." 02 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 03 * Section 1. AS 21.42.390(a) is amended to read: 04 (a) A health care insurer that offers in this state a health care insurance plan 05 that includes coverage for pharmacy services shall initially and at each renewal 06 provide coverage for the cost of treating diabetes, including medication, equipment, 07 and supplies. All health care insurance plans must include coverage for outpatient self- 08 management training or education, and medical nutrition therapy, if diabetes treatment 09 is prescribed by a health care provider. Except as provided in (d) of this section, the 10 [THE] coverage required by this section is subject to standard policy provisions 11 applicable to other benefits, including deductible or copayment provisions. Coverage 12 for the cost of diabetes outpatient self-management training or education and for the 13 cost of medical nutrition therapy is only required if provided by a health care provider 14 with training in the treatment of diabetes. 15 * Sec. 2. AS 21.42.390 is amended by adding a new subsection to read:
01 (d) Except as necessary to qualify a plan as a high deductible health plan 02 eligible for a health savings account tax deduction under 26 U.S.C. 223 (Internal 03 Revenue Code), a health care insurer that offers, issues, delivers, or renews a health 04 care insurance plan in the individual or group market in the state that provides 05 coverage for prescription drugs may not charge an insured a combined total of more 06 than $100 in cost sharing, deductibles, and copayments for coverage of a 30-day 07 supply of a prescription drug containing insulin that is used to treat diabetes. 08 * Sec. 3. AS 21.42.420 is amended to read: 09 Sec. 21.42.420. Coverage for prescription drugs; specialty drug tiers 10 prohibited. Except as provided in AS 21.42.390(d), a [A] health care insurer that 11 offers, issues, delivers, or renews a health care insurance plan in the individual or 12 group market in the state that provides coverage for prescription drugs for which cost 13 sharing, deductibles, or copayment obligations are determined by unique categories or 14 specialty tiers may impose cost sharing, deductibles, or copayment obligations for a 15 unique category or specialty tier prescription drug that exceed the dollar amount of 16 cost sharing, deductibles, or copayment obligations, as applicable, for a nonpreferred 17 brand drug or the drug's equivalent, but only if the insurer notifies the insured of the 18 cost sharing, deductible, or copayment terms applicable to unique categories or 19 specialty tiers at least 90 days before the terms apply. 20 * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 21 read: 22 APPLICABILITY. This Act applies to an insurance policy or contract issued, 23 delivered, or renewed on or after the effective date of this Act.