Bill Text: MI HB4071 | 2023-2024 | 102nd Legislature | Chaptered
Bill Title: Insurance: health insurers; coverage for orally administered anticancer chemotherapy; provide equal treatment for. Amends 1956 PA 218 (MCL 500.100 -500.8302) by adding sec. 3406ff.
Spectrum: Strong Partisan Bill (Democrat 53-3)
Status: (Passed) 2023-10-24 - Assigned Pa 170'23 [HB4071 Detail]
Download: Michigan-2023-HB4071-Chaptered.html
Act No. 170
Public Acts of 2023
Approved by the Governor
October 24, 2023
Filed with the Secretary of State
October 24, 2023
EFFECTIVE DATE: Sine Die
(91st day after final adjournment of the 2023 Regular Session
state of michigan
102nd Legislature
Regular session of 2023
Introduced by Reps. Steckloff, Fitzgerald, Brenda Carter, Byrnes, Martus, Morse, Hope, Tsernoglou, Hood, Rheingans, Rogers, Breen, Farhat, Stone, Glanville, Brabec, Coffia, Tyrone Carter, Wilson, Conlin, MacDonell, Skaggs, Paiz, Hoskins, Roth, Aiyash, Andrews, Arbit, Bezotte, Brixie, Churches, Coleman, Dievendorf, Edwards, Grant, Haadsma, Hill, Koleszar, Liberati, McFall, Mentzer, Miller, Morgan, Mueller, O'Neal, Pohutsky, Price, Puri, Scott, Shannon, Snyder, Wegela, Weiss, Whitsett, Witwer and Young
ENROLLED HOUSE BILL No. 4071
AN ACT to
amend 1956 PA 218, entitled "An act to revise, consolidate, and classify
the laws relating to the insurance and surety business; to regulate the
incorporation or formation of domestic insurance and surety companies and
associations and the admission of foreign and alien companies and associations;
to provide their rights, powers, and immunities and to prescribe the conditions
on which companies and associations organized, existing, or authorized under
this act may exercise their powers; to provide the rights, powers, and
immunities and to prescribe the conditions on which other persons, firms,
corporations, associations, risk retention groups, and purchasing groups
engaged in an insurance or surety business may exercise their powers; to
provide for the imposition of a privilege fee on domestic insurance companies
and associations and the state accident fund; to provide for the imposition of
a tax on the business of foreign and alien companies and associations; to
provide for the imposition of a tax on risk retention groups and purchasing
groups; to provide for the imposition of a tax on the business of surplus line
agents; to provide for the imposition of regulatory fees on certain insurers;
to provide for assessment fees on certain health maintenance organizations; to
modify tort liability arising out of certain accidents; to provide for limited
actions with respect to that modified tort liability and to prescribe certain
procedures for maintaining those actions; to require security for losses
arising out of certain accidents; to provide for the continued availability and
affordability of automobile insurance and homeowners insurance in this state
and to facilitate the purchase of that insurance by all residents of this state
at fair and reasonable rates; to provide for certain reporting with respect to
insurance and with respect to certain claims against uninsured or self-insured
persons; to prescribe duties for certain state departments and officers with
respect to that reporting; to provide for certain assessments; to establish and
continue certain state insurance funds; to modify and clarify the status,
rights, powers, duties, and operations of the nonprofit malpractice insurance
fund; to provide for the departmental supervision and regulation of the
insurance and surety business within this state; to provide for regulation over
worker's compensation self-insurers; to provide for the conservation,
rehabilitation, or liquidation of unsound or insolvent insurers; to provide for
the protection of policyholders, claimants, and creditors of unsound or
insolvent insurers; to provide for associations of insurers to protect policyholders
and claimants in the event of insurer insolvencies; to prescribe educational
requirements for insurance agents and solicitors; to provide for the regulation
of multiple employer welfare arrangements; to create an automobile theft
prevention authority to reduce the number of automobile thefts in this state;
to prescribe the powers and duties of the automobile theft prevention
authority; to provide certain powers and duties upon certain officials,
departments, and authorities of this state; to provide for an appropriation; to
repeal acts and parts of acts; and to provide penalties for the violation of
this act," (MCL 500.100 to 500.8302) by adding section 3406ff.
The People of the State of Michigan enact:
Sec. 3406ff. (1) A health insurance policy delivered, issued for delivery, or renewed in this state that provides coverage for prescribed orally administered antineoplastic medications and intravenously administered or injected antineoplastic medications must ensure either of the following:
(a) That financial requirements applicable to prescribed orally administered antineoplastic medications are not more restrictive than the financial requirements that apply to intravenously administered or injected antineoplastic medications that are covered by the health insurance policy.
(b) That the co-pay or coinsurance for orally administered antineoplastic medication does not exceed $250.00 per 30-day supply. Beginning January 1, 2026, and each January 1 after that date, the department shall adjust the financial requirement described in this subdivision by an amount determined by the state treasurer that reflects the cumulative annual change in the prescription drug index of the medical care component of the United States Consumer Price Index.
(2) An insurer cannot achieve compliance with this section by increasing cost-sharing requirements, reclassifying benefits with respect to antineoplastic medications, or imposing more restrictive treatment limitations on prescribed orally administered antineoplastic medications or intravenously administered or injected antineoplastic medications covered under a health insurance policy described in subsection (1).
(3) This section does not prohibit an insurer from applying utilization management techniques, including prior authorization, step therapy, limits on quantity dispensed, and days' supply per fill for any administered antineoplastic medication.
(4) As used in this section:
(a) "Antineoplastic medication" means a medication used to kill, slow, or prevent the growth of cancerous cells.
(b) "Cost-sharing requirement" means deductibles, copayments, coinsurance, out-of-pocket expenses, aggregate lifetime limits, and annual limits.
(c) "Treatment limitation" means limits on the frequency of treatment, days of coverage, or other similar limits on the scope or duration of treatment. Treatment limitation does not include the application of utilization management techniques described in subsection (3).
Enacting section 1. This amendatory act applies to health insurance policies delivered, issued for delivery, or renewed in this state after December 31, 2025.
Clerk of the House of Representatives
Secretary of the Senate
Approved___________________________________________
____________________________________________________
Governor
