Oral Parity-Enacted Laws

For many patients with cancer, intravenous chemotherapy treatments can be uncomfortable and inconvenient, as they require patients to leave the comfort of their homes to visit their clinician’s office. In recent years, alternatives to infused therapeutic treatments have begun to emerge and oral treatments have become more popular. Oral treatments allow patients to take the medication from the comfort of their homes, without being inconvenienced by burdensome doctor visits. However, increased convenience has come at a steep cost to patients, as patients taking oral chemotherapy often pay more for oral medications because insurers consider oral chemotherapy a pharmacy benefit, rather than a medical benefit like IV chemotherapy, which typically requires patients to cover a percentage of the drug’s overall cost. Fortunately, states have begun to take action to require health plans to provide the same cost-sharing requirements on both oral and IV chemotherapy treatments. The below map details which states have passed laws imposing such requirements:

Arizona:

  • Prohibits payers from charging different co-payments, deductibles, or coinsurance for
    oral anticancer treatments and intravenous anticancer treatments.

https://www.azleg.gov/legtext/51leg/2r/laws/0255.pdf


Arkansas:

  • Prohibits payers from charging different co-payments, deductibles, or coinsurance for
    oral anticancer treatments and intravenous anticancer treatments.

 https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2017R%2FPublic%2FHB1592.pdf

Colorado:

  • Prohibits payers from charging different co-insurance percentages or copayment amount
    for oral anticancer treatments at an amount higher than intravenous anticancer treatments
    co-insurance percentages or copayments.

http://www.leg.state.co.us/CLICS/CLICS2010A/csl.nsf/fsbillcont3/11E658274623C4C3872576A80026B9E5?Open&file=1202_enr.pdf

Connecticut:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://www.cga.ct.gov/2010/ACT/PA/2010PA-00063-R00SB-00050-PA.htm

Delaware:

  • Requires health plans to provide coverage of oral anticancer treatments with the same
    cost sharing as (1) anticancer medication under the prescription drug benefit; or (2)
    intravenous or injected anticancer medications, whichever has lower cost sharing.

https://legis.delaware.gov/json/BillDetail/GetHtmlDocument?fileAttachmentId=42584

Florida:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://www.flsenate.gov/Session/Bill/2013/1159/BillText/er/PDF

Georgia:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://www.billtrack50.com/billdetail/479856/29490

Hawaii:

  • Prohibits health plans from charging different co-insurance percentages or copayment
    amount for oral anticancer treatments at an amount higher than intravenous anticancer
    treatments co-insurance percentages or copayments.

https://www.capitol.hawaii.gov/Archives/measure_indiv_Archives.aspxbilltype=SB&billnumber=166&year=2009


Illinois:

  • Requires deductibles, copayments, coinsurance, and out-of-pocket expenses for orally
    administered cancer medications to be no more restrictive

https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1825&GAID=11&DocTypeID=HB&SessionID=84&GA=97

Indiana:

  • Prohibits health plans from charging less favorable co-payments, deductibles, or
    coinsurance for oral anticancer treatments than intravenous anticancer treatments.

http://archive.iga.in.gov/2009/bills/ES/ES0437.2.html

Iowa:

  • Prohibits health plans from discriminating in cost between orally administered anticancer
    medication and intravenously administered or injected cancer medications.

https://www.legis.iowa.gov/docs/publications/iactc/83.1/CH0179.pdf

Kansas:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://www.kansas.gov/government/legislative/bills/2010/390.pdf

 Kentucky:

  • Prohibits health plans from charging a higher copayment, deductible, or coinsurance
    amount of patient-administered anticancer medications than it requires for injected or
    intravenously administered anticancer medications.

https://www.billtrack50.com/billdetail/447182/29490


Louisiana:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://legis.la.gov/legis/BillInfo.aspx?s=12RS&b=HB693&sbi=y

Maine:

  • Requires health plans cover oral anticancer treatments equally to intravenous anticancer
    treatments.

http://www.mainelegislature.org/legis/bills/display_ps.asp?ld=627&PID=1456&snum=126 

Maryland:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://mgaleg.maryland.gov/2012rs/chapters_noln/ch_4_sb0179t.pdf

Massachusetts:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://legiscan.com/MA/text/S2363/2011

Minnesota:

  • Prohibits health plans from imposing higher co-payments, deductibles, or coinsurance for
    oral anticancer treatments than intravenous anticancer treatments.

https://www.revisor.mn.gov/bills/text.php?number=HF1847&session=ls86&version=latest&session_number=0&session_year=2010https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB0619&ga=112

Mississippi:

  • Prohibits health plans from imposing higher co-payments, deductibles, or coinsurance
    for oral anticancer treatments than intravenous anticancer treatments.

http://billstatus.ls.state.ms.us/documents/2015/html/HB/0900-0999/HB0952CS.htmhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2515ER+pdf

Missouri:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://house.mo.gov/Bill.aspx?bill=SB668&year=2014&code=R&cal=1

Nebraska:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments

https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=15549

Nevada:

Prohibits health plans from covering oral anticancer treatments less favorably than
intravenous anticancer treatments.

https://www.leg.state.nv.us/Session/77th2013/Reports/history.cfm?ID=654

New Hampshire:

  • Prohibits health plans from imposing higher co-payments, deductibles, or coinsurance for
    oral anticancer treatments than intravenous anticancer treatments.

http://www.gencourt.state.nh.us/legislation/2015/HB0508.html

New Jersey:

  • Requires health plans to cover oral anticancer medications under the same terms and
    conditions as injected cancer medications.

https://www.njleg.state.nj.us/Bills/2010/S2000/1834_I1.PDF 

  • New Mexico:Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments

https://www.nmlegis.gov/Sessions/11%20Regular/bills/senate/SB0385PAS.pdf

New York:

  • Requires health plans apply the lower cost sharing for oral anticancer treatments to be
    either (1) the cost of intravenous or injected anticancer medications or (2) the cost of the
    medication under the prescription drug benefit.

https://assembly.state.ny.us/leg/?default_fld=&bn=S03988&Summary=Y&Actions=Y&Text=Y&Votes=Y#S03988

North Dakota:

  • Requires plans to provide the same or lower copayment, deductible, or coinsurance for
    oral anticancer treatment medications compared to injected or intravenously administered
    anticancer treatment medications.

https://www.ndlegis.gov/assembly/64-2015/documents/15-0117-07000.pdf 

Ohio:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

http://archives.legislature.state.oh.us/bills.cfm?ID=130_SB_99

Oklahoma:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

http://webserver1.lsb.state.ok.us/cf_pdf/2013-14%20ENR/SB/SB765%20ENR.PDF

Oregon:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://olis.oregonlegislature.gov/liz/2007R1/Downloads/MeasureDocument/SB8/Enrolled

Pennsylvania:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://www.legis.state.pa.us/CFDOCS/Legis/PN/Public/btCheck.cfm?txtType=PDF&sessYr=2015&sessInd=0&billBody=H&billTyp=B&billNbr=0060&pn=3646

Rhode Island:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

http://webserver.rilin.state.ri.us/BillText13/HouseText13/H5354A.pdf

South Dakota:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    anticancer treatments.

https://legiscan.com/SD/bill/SB101/2015

Texas:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous
    or injected anticancer treatments.

https://capitol.texas.gov/tlodocs/82R/billtext/pdf/HB00438F.pdf#navpanes=0

Utah:

  • Requires health plans to ensure cost sharing for oral chemotherapy is no more restrictive
    than cost sharing for intravenously administered chemotherapy.

https://le.utah.gov/~2013/bills/sbillint/sb0189.pdf

Vermont:

  •  Requires health plans cover oral anticancer treatments no less favorably than intravenous
    or injected anticancer treatments.

https://legislature.vermont.gov/Documents/2010/Docs/ACTS/ACT061/ACT061%20As%20Enacted.pdf

Virginia:

  • Requires health plans apply the same cost-sharing criteria for both oral anticancer
    treatments and intravenously or injected anticancer treatments.

http://leg1.state.va.us/cgi-bin/legp504.exe?121+ful+SB450ER+pdf

Washington:

  • Requires health plans to provide coverage for oral chemotherapy treatment on a basis
    that is at least comparable to chemotherapy medications administered by a healthcare
    provider or facility.

https://lawfilesext.leg.wa.gov/biennium/2011-12/Pdf/Bills/House%20Passed%20Legislature/1517.PL.pdf?q=20220324091726

West Virginia:

  • Requires health plans cover oral anticancer treatments no less favorably than intravenous or injected anticancer treatments.

http://www.wvlegislature.gov/Bill_Text_HTML/2015_SESSIONS/RS/signed_bills/house/HB2493%20SUB%20ENR_signed.pdf

Wisconsin:

  • Prohibits health plans from requiring a higher copay, deductible, or coinsurance amount
    for oral chemotherapy than it requires for injected or intravenous chemotherapy.

https://docs.legis.wisconsin.gov/2013/proposals/reg/sen/bill/sb300

Wyoming:

  • Prohibits health plans from requiring a higher copay, deductible, or coinsurance amount
    for oral chemotherapy than it requires for injected or intravenous chemotherapy.

https://wyoleg.gov/2015/Enroll/SF0062.pdf

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