NC H609

Requires health benefit plans in North Carolina to cover orally administered anticancer drugs on terms no less favorable than intravenously administered or injected anticancer drugs.

Prohibits plans from imposing prior authorization requirements, dollar limits, co-payments, coinsurance, deductibles, or other out-of-pocket expenses on oral anticancer drugs that do not apply to intravenous or injected anticancer drugs.

Prevents insurers from achieving compliance by reclassifying drugs or increasing patient cost-sharing on anticancer drugs unless the same increases apply to most comparable medical or pharmaceutical benefits.

Allows insurers to comply by capping total in-network cost-sharing at $300.00 per filled prescription for oral anticancer drugs, with an exception for high deductible health plans paired with health savings accounts.

Becomes effective January 1, 2015 for insurance contracts issued, renewed, or amended on or after that date, unless federal law determines it exceeds essential health benefits requirements.