S.B. No. 194 Summary

• Prohibits health insuring corporations and sickness and accident insurers from requiring enrollees to have non-self-injectable or immediately-compounded medications delivered by mail or commercial shipment; allows alternative delivery methods.

• Requires insurance policies covering cancer chemotherapy to provide equal coverage for orally administered cancer medications compared to intravenously administered or injected cancer medications, including identical copayments, coinsurance, deductibles, and coverage limits.

• Prohibits insurance policies from placing cancer medications in more expensive price tiers or imposing more restrictive conditions on orally administered cancer medications than on injected alternatives as of the bill's effective date.

• Allows prior authorization requirements for orally administered cancer medications but prohibits other cost-sharing or coverage restrictions that are more burdensome than those for injected cancer medications.

• Establishes enforcement mechanisms through the superintendent of insurance, including cease and desist orders, license suspension or revocation, and civil penalties up to $35,000 per six-month period for violations.

• Prohibits pharmacists from delivering non-self-injectable or immediately-compounded medications to private residences unless the residence is a health care facility that has consented to the delivery.