Bill Text: MI HB5132 | 2011-2012 | 96th Legislature | Introduced
Bill Title: Insurance; health; coverage for orally administered cancer chemotherapy; provide equal treatment for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406s.
Spectrum: Partisan Bill (Republican 3-0)
Status: (Introduced - Dead) 2011-11-01 - Printed Bill Filed 10/28/2011 [HB5132 Detail]
Download: Michigan-2011-HB5132-Introduced.html
HOUSE BILL No. 5132
October 27, 2011, Introduced by Reps. Haines, Tyler and Knollenberg and referred to the Committee on Health Policy.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3406s.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3406s. (1) An expense-incurred hospital, medical, or
surgical policy or certificate delivered, issued for delivery, or
renewed in this state and a health maintenance organization group
or individual contract that provides coverage for prescribed orally
administered cancer medications and intravenously administered or
injected cancer medications shall ensure both of the following:
(a) That financial requirements applicable to prescribed
orally administered cancer medications are no more restrictive than
the financial requirements applied to intravenously administered or
injected cancer medications that are covered by the policy,
certificate, or contract and that there are no separate cost-
sharing requirements that are applicable only to prescribed orally
administered cancer medications.
(b) That treatment limitations applicable to prescribed orally
administered cancer medications are no more restrictive than the
treatment limitations applied to intravenously administered or
injected cancer medications that are covered by the policy,
certificate, or contract and that there are no separate treatment
limitations that are applicable only to prescribed orally
administered cancer medications.
(2) An insurer or health maintenance organization cannot
achieve compliance with this section by increasing financial
requirements or imposing more restrictive treatment limitations on
prescribed orally administered cancer medications or intravenously
administered or injected cancer medications covered under the
policy, certificate, or the contract on the effective date of the
amendatory act that added this section.
(3) As used in this section:
(a) "Financial requirement" means deductibles, copayments,
coinsurance, out-of-pocket expenses, aggregate lifetime limits, and
annual limits.
(b) "Treatment limitation" means limits on the frequency of
treatment, days of coverage, or other similar limits on the scope
or duration of treatment.
