§ 27-20.8-3. Copay cap for prescription insulin.
(a) As used in this section, unless the context otherwise requires, “prescription insulin drug” means a prescription drug, as defined in § 21-31-2, that contains insulin and is used to treat diabetes.
(b) A health plan that provides coverage for prescription insulin drugs pursuant to the terms of a health coverage plan the health plan offers shall cap the total amount that a covered person is required to pay for a covered prescription insulin drug at an amount not to exceed forty dollars ($40.00), per thirty-day (30) supply of insulin. Coverage for prescription insulin drugs shall not be subject to any deductible.
(c) Nothing in this section prevents a health plan from reducing a covered person’s cost sharing to an amount less than the amount specified in subsection (b) of this section.
(d) The office of the health insurance commissioner may use any of its enforcement powers to obtain a health plan’s compliance with this section.
(e) The office of the health insurance commissioner may promulgate rules and regulations as necessary to implement and administer this section and to align with federal requirements.
History of Section.
P.L. 2021, ch. 110, § 1, effective January 1, 2022; P.L. 2021, ch. 163, § 1, effective
January 1, 2022.