Raised Bill No. 5175 - Diabetes and High Deductible Health Plans

• Requires individual and group health insurance policies to cover all types of diabetes treatment including insulin drugs, non-insulin drugs, laboratory testing, and diabetes equipment and supplies effective January 1, 2021.

• Caps out-of-pocket expenses at $50 per 30-day supply for insulin drugs, $50 per 30-day supply for non-insulin drugs, and $100 per 30-day supply for diabetes equipment and supplies, with combined monthly maximums of $100 for insulin drugs and equipment combined.

• Allows licensed pharmacists to dispense prescription insulin drugs and diabetes equipment without a valid prescription when they determine the individual would suffer immediate physical harm without such items, dispensing only the minimum amount necessary.

• Requires the Commissioner of Social Services to study the feasibility of creating a fund to assist low-income diabetic individuals in paying for insulin and diabetes treatment supplies, with a report due by January 1, 2021.

• Makes conforming changes to high deductible health plan provisions across multiple insurance statutes to align with federal Internal Revenue Code requirements regarding medical savings accounts and health savings accounts, effective October 1, 2020.