Amendments for SB23-195
Senate Journal, March 31
After consideration on the merits, the Committee recommends that SB23-195 be amended
as follows, and as so amended, be referred to the Committee on Appropriations with
favorable recommendation.
Amend printed bill, page 4, line 1, strike "definition. (1)" and substitute
"definitions - rules. (1) (a)".
Page 4, line 6, strike "PERSON." and substitute "PERSON FOR A PRESCRIPTION
DRUG IF:
(I) THE PRESCRIPTION DRUG DOES NOT HAVE A GENERIC EQUIVALENT;
OR
(II) THE PRESCRIPTION DRUG HAS A GENERIC EQUIVALENT, AND THE
COVERED PERSON IS USING THE BRAND-NAME PRESCRIPTION DRUG AFTER:
(A) OBTAINING PRIOR AUTHORIZATION FROM THE CARRIER OR
PHARMACY BENEFIT MANAGER;
(B) COMPLYING WITH A STEP-THERAPY PROTOCOL REQUIRED BY THE
CARRIER OR PHARMACY BENEFIT MANAGER; OR
(C) RECEIVING APPROVAL FROM THE CARRIER OR PHARMACY BENEFIT
MANAGER THROUGH THE CARRIER'S OR PHARMACY BENEFIT MANAGER'S
EXCEPTIONS, APPEAL, OR REVIEW PROCESS.
(b) IF A COVERED PERSON IS ENROLLED IN OR PARTICIPATING IN A COPAY
ASSISTANCE PROGRAM OFFERED BY A PRESCRIPTION DRUG MANUFACTURER
THAT REDUCES OR ELIMINATES THE COVERED PERSON'S OUT-OF-POCKET
EXPENSES FOR A PRESCRIPTION DRUG COVERED UNDER THE COVERED PERSON'S
HEALTH BENEFIT PLAN, THE PRESCRIPTION DRUG MANUFACTURER MUST OFFER
THE COPAY ASSISTANCE PROGRAM TO THE COVERED PERSON EITHER FOR THE
ENTIRE PLAN YEAR OR FOR THE CALENDAR YEAR, WHICHEVER THE DEDUCTIBLE
AND OUT-OF-POCKET CALCULATION APPLIES TO, AS LONG AS THE COVERED
PERSON IS ENROLLED IN THE HEALTH BENEFIT PLAN.".
Page 4, after line 17 insert:
"(3) THE COMMISSIONER MAY ADOPT RULES AS NECESSARY TO
IMPLEMENT THIS SECTION.".
Renumber succeeding subsection accordingly.
Page 4, line 18, strike "SECTION, "COST-SHARING" and substitute "SECTION:
(a) "COPAY ASSISTANCE PROGRAM" MEANS A PROGRAM OFFERED BY
THE MANUFACTURER OF A PRESCRIPTION DRUG, INCLUDING A COUPON OR OTHER
DISCOUNT, THAT REDUCES OR ELIMINATES THE OUT-OF-POCKET COST THAT A
COVERED PERSON MUST PAY FOR A PRESCRIPTION DRUG.
(b) "COST-SHARING".
Page 4, lines 22 and 23, strike "A SPECIFIC HEALTH-CARE SERVICE, INCLUDING".
Page 4, line 23, strike "OR DEVICE,".
Strike "coverage" and substitute "benefit" on: Page 2, lines 18 and 24; Page 3,
lines 3, 11, and 24; and Page 5, line 9.
Strike "COVERAGE" and substitute "BENEFIT" on: Page 4, lines 4, 12, and 24.
Page 1, line, 103, strike "COVERAGE" and substitute "BENEFIT".
House Journal, April 25
20 SB23-195 be amended as follows, and as so amended, be referred to
21 the Committee on Appropriations with favorable
22 recommendation:
23
24 Amend reengrossed bill, page 4, strike line 9 and substitute "EQUIVALENT
25 OR, FOR A PRESCRIPTION DRUG THAT IS A BIOLOGICAL PRODUCT, THE
26 PRESCRIPTION DRUG DOES NOT HAVE A BIOSIMILAR DRUG, AS DEFINED IN
27 42 U.S.C. SEC. 262 (i)(2), OR AN INTERCHANGEABLE BIOLOGICAL
28 PRODUCT, AS DEFINED IN 42 U.S.C. SEC. 262 (i)(3); OR".
29
30 Page 4, line 10, after "EQUIVALENT," insert "A BIOSIMILAR DRUG, OR AN
31 INTERCHANGEABLE BIOLOGICAL PRODUCT,".
32
33 Page 4, strike lines 20 through 27.
34
35 Page 5, strike lines 1 and 2 and substitute:
36
37 "(b) A COVERED PERSON IS NOT REQUIRED TO COMPLY WITH THE
38 UTILIZATION MANAGEMENT PROCESSES DESCRIBED IN SUBSECTION
39 (1)(a)(II) OF THIS SECTION, INCLUDING PRIOR AUTHORIZATION AND
40 STEP-THERAPY PROTOCOL REQUIREMENTS, WHEN THOSE PROCESSES ARE
41 PROHIBITED UNDER THIS ARTICLE 16 OR OTHER APPLICABLE STATE LAW.".
42
43 Page 5, strike lines 16 through 21 and substitute:
44
45 "(4) AS USED IN THIS SECTION, "COST-SHARING REQUIREMENT"
46 MEANS ANY COPAYMENT,".
47
48