AB 622

This bill prohibits a health insurance policy, known in the bill as a disability

insurance policy, or self-insured governmental health plan from denying or allowing

a pharmacy benefit manager to deny coverage to an insured or plan participant

during a current policy or plan year for a prescribed drug or device if 1) the prescribed

drug or device was covered under the policy or plan for the insured or plan

participant when the insured or plan participant either enrolled in coverage or

renewed coverage, whichever is later and 2) a health care provider who prescribed

the prescribed drug or device states, in writing, that the prescribed drug or device

is more suitable for the insured's or plan participant's condition than alternative

drugs or devices that remain covered under the policy or plan. The bill also prohibits

a policy or plan from subjecting such a prescribed drug or device to exclusions,

limitations, deductibles, copayments, or coinsurance that did not apply to the

prescribed drug or device when the insured or plan participant either enrolled or

renewed coverage in the policy or plan.

This proposal may contain a health insurance mandate requiring a social and

financial impact report under s. 601.423, stats.