Sub. H.B. No. 418 Summary

• Health plan issuers are prohibited during a plan year from increasing a covered person's cost-sharing burden for drugs, moving drugs to more restrictive formulary tiers, or limiting drug coverage except through prior authorization requirements.

• Health plan issuers may only remove drugs from formularies if the FDA issues a safety statement, the manufacturer discontinues production, or the drug is removed from sale in the United States.

• The bill allows pharmacists to substitute generic equivalent drugs or interchangeable biological products for prescribed drugs, and permits covered persons to use generically equivalent drugs even when they become available mid-plan-year, without prior authorization requirements.

• Health plan issuers may still add drugs to formularies and pharmacists may substitute alternative epinephrine autoinjectors under state pharmacy law.

• Violations are classified as unfair and deceptive insurance practices and the act applies to plans delivered, issued, modified, or renewed on or after the effective date.