HB18-1370 Summary

• Prohibits health insurance carriers from excluding, limiting, or moving to a disadvantaged tier any drug that was covered when a covered person enrolled in their health benefit plan, provided the prescribing provider continues prescribing it and it remains safe and effective.

• Prohibits carriers from increasing copayments, coinsurance, deductibles, or setting coverage limits for drugs that were covered at the time of enrollment.

• Allows carriers to move a drug to a disadvantaged tier in tiered formularies only if the prescribing provider prescribes a generic drug or biosimilar product that is therapeutically equivalent and the covered person agrees.

• Creates new statute section 10-16-147 to establish continuity of coverage requirements for approved drugs under health benefit plans.

• Takes effect August 8, 2018, or later if subject to a referendum petition requiring voter approval in November 2018.