MO HB1681

Health carriers and pharmacy benefits managers must count payments made by or on behalf of enrollees toward out-of-pocket maximums and cost-sharing requirements for medications without generic substitutes available

Prohibits health carriers and pharmacy benefits managers from adjusting out-of-pocket maximums or cost-sharing based on the availability of manufacturer cost-sharing assistance programs for medications without generic alternatives

For health savings account-qualified high deductible plans, the cost-sharing requirements apply after the enrollee meets the minimum deductible under IRS Section 223, except for preventive care services

Does not apply to health benefit plans covered under the federal Labor Management Relations Act of 1947 (LMRA)

Applies to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026