Bill Text: MI SB0541 | 2011-2012 | 96th Legislature | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft
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-Introduced.html

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SENATE BILL No. 541

 

 

June 29, 2011, Introduced by Senators KAHN, CASWELL, BOOHER, COLBECK, GREEN, PROOS, PAPPAGEORGE, KOWALL and BIEDA and referred to the Committee on Insurance.

 

 

 

     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) 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.

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