OH SB135

Caps out-of-pocket cost sharing for specialty drugs at $150 per month for health insuring corporation policies, sickness and accident insurance policies, and public employee benefit plans.

Defines "specialty drug" as a prescription drug costing $600+ for a 30-day supply prescribed for complex, chronic, or rare medical conditions that requires special handling or enhanced patient support.

Requires health plans to establish a process allowing covered individuals to request coverage of specialty drugs not on preferred drug formularies, with denials subject to internal appeal and external review.

Prohibits placing all drugs in a given class on a specialty tier and allows plans to use designated pharmacies and utilization management techniques like prior authorization.

Applies to policies, contracts, and arrangements delivered, issued for delivery, or renewed on or after January 1, 2016.