S.B. No. 493 Summary

• Prohibits health insurers from requiring step therapy for stage two cancer patients before covering FDA-approved drugs prescribed by their health care provider, if the drug is on the insurer's formulary and consistent with best practices.

• Applies to individual and group accident/health policies, hospital/medical service plans, and health maintenance organization plans issued or renewed after December 31, 2019.

• Exempts investigational new drugs from the step therapy prohibition.

• Requires the state auditor to review and report by 20 days before the 2020 legislative session on whether the mandate triggers federal ACA requirements, state sunrise analysis requirements, or conflicts with medical necessity provisions.

• Effective date: July 1, 2050.