An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for prescription drug cost credits in health insurance; and imposing penalties.
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Overview
This bill creates prescription drug cost credits for health insurance policyholders in Pennsylvania. It requires health insurance coverage administrators to credit out-of-pocket expenses paid for prescription drugs, up to a certain limit, to a covered person's in-network out-of-pocket maximum. The bill also establishes a process for submitting proof of purchase and includes penalties for non-compliance, with exemptions for transparent pricing models offered by pharmacies.
Key provisions
- Establishes prescription drug cost credits for out-of-pocket expenses.
- Requires health insurers to apply credits to in-network out-of-pocket maximums.
- Creates a process for covered persons to submit proof of purchase for reimbursement.
- Defines key terms related to prescription drugs and health insurance.
- Specifies penalties for non-compliance, including fines and license suspension.
- Provides a process for submitting proof of purchase.
- Establishes a maximum out-of-pocket limit for credits.
Who is affected
- Health insurance policyholders
- Health insurance coverage administrators
- Health insurers
- Pharmacies
- Prescription drug coverage administrators
Notable changes
- Introduces a system for prescription drug cost credits within health insurance plans.
Bill text
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Document of record
- Version
- Pn 3661 Html
- Published
- Not published in the source record
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Sponsors
Official sponsors from legislative records.
9 on record
Primary sponsor
Cosponsors
Benjamin Sanchez
Daniel Deasy
Danielle Friel Otten
Arguments
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