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MI HB5944
Bill
Status
7/21/2020
Primary Sponsor
Ben Frederick
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AI Summary
HB 5944 Summary
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Requires health insurance policies delivered, issued, or renewed after December 31, 2021 to apply amounts paid by the insured or third parties toward out-of-pocket maximums and cost-sharing requirements for prescription drug coverage.
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Excludes direct manufacturer support and payments from "unauthorized payers" (those prohibited by federal law, state law, or contractual requirements) from counting toward cost-sharing obligations.
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Defines "cost-sharing requirement" to include copayments, coinsurance, deductibles, and annual limitations on cost sharing required to receive covered health care services or prescription drugs.
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Applies to all health insurance policies in Michigan covering prescription drugs, subject to limitations in the Health Care False Claims Act.
Legislative Description
Insurance: health benefits; application of amount paid by the insured or other certain parties when calculating the insured's co-pay for a prescription drug; require under certain conditions. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406v.
Health: pharmaceuticals
Last Action
Referred To Committee On Ways And Means, With Substitute (h-1)
9/24/2020