Okla. Stat. tit. 36, § 36-6060.9a
This is the official text of Okla. Stat. tit. 36, § 36-6060.9a, part of Oklahoma’s Stat. tit. 36, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 36,." Browse the sections below, each linked to its official government source.
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Anti-cancer medication coverage
Official statutory text
A. 1. Any health benefit plan that provides coverage and
benefits for cancer treatment shall provide coverage of prescribed
orally administered anticancer medications on a basis no less
favorable than intravenously administered or injected cancer
medications.
2. Coverage of orally administered anticancer medication shall
not be subject to any prior authorization, dollar limit, copayment,
deductible, or other out-of-pocket expense that does not apply to
intravenously administered or injected cancer medication, regardless
of formulation or benefit category determination by the company
administering the health benefit plan.
3. A health benefit plan shall not reclassify or increase any
type of cost-sharing to the covered person for anticancer
medications in order to achieve compliance with this section. Any
change in health insurance coverage that otherwise increases an out-
of-pocket expense to anticancer medications shall also be applied to
the majority of comparable medical or pharmaceutical benefits
covered by the health benefit plan.
4. A health benefit plan that limits the total amount paid by a
covered person through all cost-sharing requirements to no more than
One Hundred Dollars ($100.00) per filled prescription for any orally
administered anticancer medication shall be considered in compliance
with this section. For purposes of this paragraph, "cost-sharing
requirements" shall include copayments, coinsurance, deductibles,
and any other amounts paid by the covered person for that
prescription.
B. As used in this section:
1. "Anticancer medications" means medications used to kill or
slow the growth of cancer cells;
2. "Covered person" means a policyholder, subscriber, enrollee,
or other individual enrolled in or insured by a health benefit plan
for health insurance coverage; and
3. "Health benefit plan" means any plan or arrangement as
defined in subsection C of Section 6060.4 of Title 36 of the
Oklahoma Statutes.
benefits for cancer treatment shall provide coverage of prescribed
orally administered anticancer medications on a basis no less
favorable than intravenously administered or injected cancer
medications.
2. Coverage of orally administered anticancer medication shall
not be subject to any prior authorization, dollar limit, copayment,
deductible, or other out-of-pocket expense that does not apply to
intravenously administered or injected cancer medication, regardless
of formulation or benefit category determination by the company
administering the health benefit plan.
3. A health benefit plan shall not reclassify or increase any
type of cost-sharing to the covered person for anticancer
medications in order to achieve compliance with this section. Any
change in health insurance coverage that otherwise increases an out-
of-pocket expense to anticancer medications shall also be applied to
the majority of comparable medical or pharmaceutical benefits
covered by the health benefit plan.
4. A health benefit plan that limits the total amount paid by a
covered person through all cost-sharing requirements to no more than
One Hundred Dollars ($100.00) per filled prescription for any orally
administered anticancer medication shall be considered in compliance
with this section. For purposes of this paragraph, "cost-sharing
requirements" shall include copayments, coinsurance, deductibles,
and any other amounts paid by the covered person for that
prescription.
B. As used in this section:
1. "Anticancer medications" means medications used to kill or
slow the growth of cancer cells;
2. "Covered person" means a policyholder, subscriber, enrollee,
or other individual enrolled in or insured by a health benefit plan
for health insurance coverage; and
3. "Health benefit plan" means any plan or arrangement as
defined in subsection C of Section 6060.4 of Title 36 of the
Oklahoma Statutes.
Status: in_force · Read it on the official government site
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