SCS/SB 384 - This act modifies provisions relating to prescription drugs. Under this act, any health benefit plan that provides coverage and benefits for cancer chemotherapy treatment shall not require a higher copayment, deductible, or coinsurance amount for a prescribed, orally administered anticancer medication that is used to kill or slow the growth of cancerous cells than what the plan requires for an intravenously administered or injected cancer medication that is provided, regardless of formulation or benefit category determination by the health carrier administering the health benefit plan. A health carrier shall not achieve compliance with the provisions of the act by imposing an increase in copayment, deductible, or coinsurance amount for an intravenously administered or injected cancer chemotherapy agent covered under the health benefit plan.
This provision is identical to SB 262 (2011).
This act provides that a pharmacy benefit manager shall be civilly liable to a patient for any switch communication, decision, denial or action that damages the patient. Such patient may bring a civil action against the pharmacy benefit manager to recover the actual damages sustained by the patient, court costs, including reasonable attorney's fees, and punitive damages, when determined to be appropriate by the court. A "switch communication" is a communication to a patient or the patient's physician from a health carrier or pharmacy benefit manager that recommends a patient's medication or device be switched by the original prescribing practitioner to a different medication than the medication or device originally prescribed by the prescribing practitioner.
ADRIANE CROUSE