December 1, 2015, Introduced by Senators HANSEN, GREEN, COLBECK, JONES, BIEDA, YOUNG, WARREN, PROOS, KNOLLENBERG, BOOHER, HILDENBRAND, MARLEAU and HERTEL and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3406t.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3406t. (1) An expense-incurred hospital, medical, or
surgical policy or certificate delivered, issued for delivery, or
renewed in this state and a health maintenance organization group
or individual contract that provides coverage for prescribed orally
administered anticancer medications and intravenously administered
or injected anticancer medications must ensure both of the
following:
(a) That financial requirements applicable to prescribed
orally administered anticancer medications are no more restrictive
than the financial requirements applied to intravenously
administered or injected anticancer medications that are covered by
the policy, certificate, or contract and that there are no separate
cost-sharing requirements that are applicable only to prescribed
orally administered anticancer medications.
(b) That treatment limitations applicable to prescribed orally
administered anticancer medications are no more restrictive than
the treatment limitations applied to intravenously administered or
injected anticancer medications that are covered by the policy,
certificate, or contract and that there are no separate treatment
limitations that are applicable only to prescribed orally
administered anticancer medications.
(2) An insurer or health maintenance organization cannot
achieve compliance with this section by increasing financial
requirements, reclassifying benefits with respect to anticancer
medications, or imposing more restrictive treatment limitations on
prescribed orally administered anticancer medications or
intravenously administered or injected anticancer medications
covered under the policy, certificate, or contract on the effective
date of the amendatory act that added this section.
(3) As used in this section:
(a) "Anticancer medication" means a medication used to kill,
slow, or prevent 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.