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GA SB76
Bill
Status
Engrossed
3/6/2023
Primary Sponsor
Nikki Merritt
Click for details
AI Summary
- Caps out-of-pocket costs for covered insulin medication under Georgia state health benefit plans at $35.00 per 30-day supply or $105.00 per 90-day supply, effective January 1, 2024, regardless of insulin type or number of prescriptions
- Defines "covered insulin medication" as insulin prescribed to treat diabetes, excluding insulin prescribed for weight loss or administered intravenously
- Requires insurers under contract with state health benefit plans to include at least one covered insulin medication from each therapeutic class in their formulary and prohibits them from applying deductibles, imposing prior authorization, or reducing coverage for covered insulin
- Allows insurers to set cost-sharing requirements lower than the statutory caps but not higher
- Beginning January 1, 2025, and annually thereafter, the cost-sharing caps will be adjusted based on the percentage change in the prescription drug component of the Consumer Price Index
Legislative Description
State Employees' Health Insurance Plan; state health benefit plans to cover insulin medication at a reduced rate; provide
Last Action
House Passed/Adopted By Substitute
3/28/2024
Committee Referrals
Health3/7/2023
Insurance and Labor2/6/2023
Full Bill Text
No bill text available