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MI HB5204
Bill
Status
11/4/2025
Primary Sponsor
Brenda Carter
Click for details
AI Summary
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Prohibits health insurers from requiring patients with advanced metastatic cancer to fail on a different prescription drug before receiving coverage for their prescribed medication (known as "step therapy" or "fail first" requirements)
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Applies to prescription drugs used to treat advanced metastatic cancer and associated conditions, including symptoms and side effects of the cancer or its treatment
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Defines advanced metastatic cancer as cancer that has spread from the original site to nearby tissues, lymph nodes, or other parts of the body
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Amends the Insurance Code of 1956 by adding Section 3406rr to regulate health insurance policies that provide prescription drug coverage
Legislative Description
Insurance: health insurers; prescription drug coverage for metastatic cancer; prohibit certain conditions. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406rr.
Insurance: health insurers
Last Action
Bill Electronically Reproduced 11/04/2025
11/5/2025