A bill to amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider.
Cancer Drug Parity Act of 2021
This bill requires group health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications. This requirement applies to medications that are (1) approved by the Food and Drug Administration; (2) medically necessary for the cancer treatment; and (3) clinically appropriate in terms of type, frequency, extent site, and duration.
To comply with this requirement, plans may not, with respect to anticancer medications (1) change or replace benefits to increase out-of-pocket costs, (2) reclassify benefits to increase costs, or (3) apply more restrictive limitations to orally administered medications than to intravenously administered or injected medications.
Referred to the House Committee on Education and Labor.
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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