KS SB423

Health insurers, pharmacy benefits managers, and pharmacy administrative services organizations must count third-party payments (such as manufacturer copay assistance) toward a patient's deductible and out-of-pocket maximum for prescription drugs

Applies to brand-name drugs without a generic equivalent, biosimilar, or interchangeable biological product available

Also applies to brand-name drugs when a generic exists if the patient obtained prior authorization, completed step-therapy requirements, or received approval through an exceptions/appeals process

For health savings account (HSA)-eligible plans, the requirement applies only after the patient meets the minimum deductible under 26 U.S.C. § 223, except for preventive care items which are covered regardless

The Kansas Insurance Commissioner is directed to adopt rules and regulations to implement these provisions