Bill Text: OH SB138 | 2009-2010 | 128th General Assembly | Introduced
Bill Title: To require certain insurers that provide coverage for cancer chemotherapy treatment to provide coverage for certain prescribed, orally administered anticancer medication on a basis no less favorable than intravenously administered or injected cancer medications that are covered under the policy.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2009-06-16 - To Insurance, Commerce, & Labor [SB138 Detail]
Download: Ohio-2009-SB138-Introduced.html
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Senator Miller, R.
| To amend section 1739.05 and to enact sections | 1 |
| 1751.69 and 3923.85 of the Revised Code to require | 2 |
| certain insurers that provide coverage for cancer | 3 |
| chemotherapy treatment to provide coverage for | 4 |
| certain prescribed, orally administered anticancer | 5 |
| medication on a basis no less favorable than | 6 |
| intravenously administered or injected cancer | 7 |
| medications that are covered under the policy. | 8 |
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
| Section 1. That section 1739.05 be amended and sections | 9 |
| 1751.69 and 3923.85 of the Revised Code be enacted to read as | 10 |
| follows: | 11 |
| Sec. 1739.05. (A) A multiple employer welfare arrangement | 12 |
| that is created pursuant to sections 1739.01 to 1739.22 of the | 13 |
| Revised Code and that operates a group self-insurance program may | 14 |
| be established only if any of the following applies: | 15 |
| (1) The arrangement has and maintains a minimum enrollment of | 16 |
| three hundred employees of two or more employers. | 17 |
| (2) The arrangement has and maintains a minimum enrollment of | 18 |
| three hundred self-employed individuals. | 19 |
| (3) The arrangement has and maintains a minimum enrollment of | 20 |
| three hundred employees or self-employed individuals in any | 21 |
| combination of divisions (A)(1) and (2) of this section. | 22 |
| (B) A multiple employer welfare arrangement that is created | 23 |
| pursuant to sections 1739.01 to 1739.22 of the Revised Code and | 24 |
| that operates a group self-insurance program shall comply with all | 25 |
| laws applicable to self-funded programs in this state, including | 26 |
| sections 3901.04, 3901.041, 3901.19 to 3901.26, 3901.38, 3901.381 | 27 |
| to 3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to 3902.14, | 28 |
| 3923.282, 3923.30, 3923.301, 3923.38, 3923.581, 3923.63, 3923.80, | 29 |
| 3923.85, 3924.031, 3924.032, and 3924.27 of the Revised Code. | 30 |
| (C) A multiple employer welfare arrangement created pursuant | 31 |
| to sections 1739.01 to 1739.22 of the Revised Code shall solicit | 32 |
| enrollments only through agents or solicitors licensed pursuant to | 33 |
| Chapter 3905. of the Revised Code to sell or solicit sickness and | 34 |
| accident insurance. | 35 |
| (D) A multiple employer welfare arrangement created pursuant | 36 |
| to sections 1739.01 to 1739.22 of the Revised Code shall provide | 37 |
| benefits only to individuals who are members, employees of | 38 |
| members, or the dependents of members or employees, or are | 39 |
| eligible for continuation of coverage under section 1751.53 or | 40 |
| 3923.38 of the Revised Code or under Title X of the "Consolidated | 41 |
| Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29 | 42 |
| U.S.C.A. 1161, as amended. | 43 |
| Sec. 1751.69. Notwithstanding section 3901.71 of the Revised | 44 |
| Code, each individual or group health insuring corporation policy, | 45 |
| contract, or agreement providing basic health care services that | 46 |
| is delivered, issued for delivery, or renewed in this state that | 47 |
| provides coverage for cancer chemotherapy treatment shall provide | 48 |
| coverage for a prescribed, orally administered anticancer | 49 |
| medication used to kill or slow the growth of cancerous cells on a | 50 |
| basis no less favorable than intravenously administered or | 51 |
| injected cancer medications that are covered under the policy, | 52 |
| contract, or agreement. | 53 |
| Sec. 3923.85. Notwithstanding section 3901.71 of the Revised | 54 |
| Code, each individual or group policy of sickness and accident | 55 |
| insurance that is delivered, issued for delivery, or renewed in | 56 |
| this state or public employee benefit plan that is established or | 57 |
| modified in this state that provides coverage for cancer | 58 |
| chemotherapy treatment shall provide coverage for a prescribed, | 59 |
| orally administered anticancer medication used to kill or slow the | 60 |
| growth of cancerous cells on a basis no less favorable than | 61 |
| intravenously administered or injected cancer medications that are | 62 |
| covered under the policy or plan. | 63 |
| This section does not apply to the offer or renewal of any | 64 |
| individual or group policy of sickness and accident insurance that | 65 |
| provides coverage for specific diseases or accidents only, or to | 66 |
| any hospital indemnity, medicare supplement, medicare, tricare, | 67 |
| long-term care, disability income, one-time limited duration | 68 |
| policy of not longer than six months, or other policy that offers | 69 |
| only supplemental benefits. | 70 |
| Section 2. That existing section 1739.05 of the Revised Code | 71 |
| is hereby repealed. | 72 |
| Section 3. Sections 1751.69 and 3923.85 of the Revised Code, | 73 |
| as enacted by this act, shall apply only to policies, contracts, | 74 |
| agreements, and plans that are delivered, issued for delivery, | 75 |
| renewed, established, or modified in this state on or after the | 76 |
| effective date of this act. | 77 |
