Bill Text: MI SB0541 | 2011-2012 | 96th Legislature | Engrossed
Bill Title: Insurance; health care corporations; coverage for orally administered cancer chemotherapy; provide equal treatment for. Amends 1980 PA 350 (MCL 550.1101 - 550.1704) by adding sec. 416e.
Spectrum: Moderate Partisan Bill (Republican 8-1)
Status: (Engrossed - Dead) 2011-12-14 - Referred To Committee On Health Policy [SB0541 Detail]
Download: Michigan-2011-SB0541-Engrossed.html
SB-0541, As Passed Senate, December 14, 2011
SUBSTITUTE FOR
SENATE BILL NO. 541
A bill to amend 1980 PA 350, entitled
"The nonprofit health care corporation reform act,"
(MCL 550.1101 to 550.1704) by adding section 416e.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 416e. (1) A health care corporation group or nongroup
certificate 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 certificate 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 certificate and
that there are no separate treatment limitations that are
applicable only to prescribed orally administered cancer
medications.
(2) A health care corporation 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 certificate on the effective date of
the amendatory act that added this section.
(3) This section does not prohibit a health care corporation
from increasing cost-sharing for all benefits.
(4) This section does not prohibit a health care corporation
from applying utilization management techniques, including prior
authorization, step therapy, limits on quantity dispensed, and
days' supply per fill for an orally administered cancer medication.
(5) As used in this section:
(a) "Cancer medication" means a medication used to kill or
slow the growth of cancerous cells.
(b) "Financial 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.
Enacting section 1. This amendatory act takes effect 6 months
after the date it is enacted into law.
