CS/HB 1363 Summary

• Prohibits individual and group insurance policies with medical coverage from removing prescription drugs from formularies or reclassifying drugs to more restrictive tiers during a policy year, except when FDA questions drug safety or manufacturer discontinues the drug.

• Allows insurers to add new prescription drugs to formularies during the policy year and makes exceptions for grandfathered health plans, Medicaid managed care plans, and does not restrict generic substitution by pharmacists.

• Requires small employer carriers to limit prescription drug formulary changes in the same manner as individual and group policies under the Employee Health Care Access Act.

• Extends the same formulary change restrictions to health maintenance organizations and their contracts, prohibiting removals or reclassifications mid-contract year except for safety or discontinuance reasons.

• Takes effect January 1, 2020, with Legislature declaring this fulfills an important state interest in consumer protection.