Prohibiting elimination of covered prescription drugs or devices during a contract year for certain health care plans

What it would have done

Summary by the Legislative Reference Bureau, the Legislature's nonpartisan drafting office. It's their wording, not ours.

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.

Who's behind it

5 senators are its authors⁠. All 5 are Democrats.

24 more lawmakers signed on in support⁠.