SB 1182 - This act prohibits health benefit plans from imposing cost-sharing, as defined in the act, on an enrollee in excess of $30 per 30-day supply of a prescription insulin drug. This act also requires health benefit plan enrollees' cost-sharing for prescription insulin drugs to be calculated at the point of sale, and based on a price that is reduced by an amount equal to at least 100% of all rebates received, or to be received, in connection with the dispensing or administration of the drug. Nothing in the act shall prohibit copayments not based on the price of a drug, provided that the copayment does not exceed the reduced price of the drug.
The act shall not require a health carrier or its agents to reveal information regarding the actual amount of rebates a carrier receives on a product, manufacturer, or pharmacy-specific basis. The act also provides confidentiality protections, as specified in the act, which the carriers shall follow as well as impose on any third party that performs health care or administrative services on behalf of the carrier and may receive or have access to rebate information.
This act applies to health benefit plans delivered, issued, continued, or renewed in the state on or after January 1, 2025.
This act is similar to HB 2262 (2024), identical to SB 283 (2023), and similar to SB 815 (2022), SB 264 (2021), provisions in HB 2682 (2020), and provisions in HB 1987 (2020), and contains provisions similar to SB 814 (2022), and SB 112 (2021).
ERIC VANDER WEERD