MissouriCreates provisions relating to cost-sharing under health benefit plans
What it does
This act provides that when calculating an enrollee's overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available.
More detail
Additionally, no health carrier or pharmacy benefits manager shall design benefits in a manner that takes into account the availability of any cost-sharing assistance program for any medication for which a generic drug substitute is not available.
The provisions of this act shall apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026.
This act is similar to HB 79 (2025) and substantially similar to provisions in SB 45 (2025), and similar to provisions in SB 187 (2025), SB 512 (2025), SB 1106 (2024), SB 844 (2024), SB 1190 (2024), HCS/HB 442 (2023), HB 1628 (2024), SB 269 (2023), and SB 1031 (2022). TAYLOR MIDDLETON
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- May 15Informal Calendar S Bills for PerfectionLatest
- Mar 4SS for SCS S offered (Fitzwater)--(5021S.03F)
- Mar 4SA 1 to SS for SCS S offered & defeated (Lewis)--(5021S03.03S)
- Mar 4SA 2 to SS for SCS S offered & adopted (Beck)--(5021S03.07S)
- Mar 4Bill Placed on Informal Calendar
- Mar 3Bill Placed on Informal Calendar
- Feb 19Reported from S Families, Seniors and Health Committee w/SCS
- Feb 4SCS Voted Do Pass S Families, Seniors and Health Committee (5021S.02C)Minor
- Jan 14Hearing Conducted S Families, Seniors and Health Committee
- Jan 8Second Read and Referred S Families, Seniors and Health CommitteeMinor
- Jan 7S First ReadMinor
- 2025
- Dec 1PrefiledIntroduced