MS HB93

Prohibits health insurance plans from modifying an insured's contracted benefit level on renewal for any prescription drug that was approved, covered, and prescribed during the immediately preceding plan year for a medical condition or mental illness, effective July 1, 2025.

Applies to individual and group health insurance policies, service contracts, health maintenance organizations, self-insured group arrangements, and managed health care delivery entities operating in Mississippi.

Specifically prohibits removing drugs from formularies, adding prior authorization requirements, imposing or altering quantity limits, imposing step-therapy restrictions, moving drugs to higher cost-sharing tiers, increasing out-of-pocket expenses, and reducing maximum drug coverage amounts.

Allows insurers to remove drugs from coverage if the FDA issues a clinical safety statement, the drug manufacturer notifies the FDA of discontinuance, or the manufacturer removes the drug from the market.

Requirement applies only if the insured was covered immediately before renewal and a physician determines in consultation with the insured that the drug remains the most appropriate course of treatment.