Adds to existing law to establish provisions regarding coverage of anticancer medications under health benefit plans.
INSURANCE -- Adds to existing law to establish provisions regarding coverage of anticancer medications under health benefit plans.
STATEMENT OF PURPOSE
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The purpose of this legislation is to create co-insurance parity for cancer treatment patient cost regardless of treatment being intravenously administered, injected, or orally taken. The legislation directs the Department of Insurance to ensure state regulated health plans, when anti-cancer medication is covered by a health plan, to provide patients access to orally administered anti-cancer medications at a co-insurance rate no more than the cost to access injected or intravenously administered medication.
FISCAL NOTE
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This legislation causes no increase or decrease in revenue, or additional expenditure of funds at the state or local level of government; therefore, this legislation has no fiscal impact.
BILL TEXT
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LEGISLATURE OF THE STATE OF IDAHO Sixty-eighth Legislature Second Regular Session - 2026 IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 530 BY HEALTH AND WELFARE COMMITTEE AN ACT1 RELATING TO HEALTH INSURANCE; AMENDING CHAPTER 18, TITLE 41, IDAHO CODE, BY2 THE ADDITION OF A NEW SECTION 41-1854, IDAHO CODE, TO ESTABLISH PROVI-3 SIONS REGARDING ANTICANCER MEDICATIONS; AND DECLARING AN EMERGENCY AND4 PROVIDING AN EFFECTIVE DATE.5
Be It Enacted by the Legislature of the State of Idaho:6
SECTION 1. That Chapter 18, Title 41, Idaho Code, be, and the same is7 hereby amended by the addition thereto of a NEW SECTION, to be known and des-8 ignated as Section 41-1854, Idaho Code, and to read as follows:9 41-1854. ANTICANCER MEDICATIONS. (1) For purposes of this section:10 (a) "Anticancer medication" means a drug or biologic used to kill,11 slow, or prevent the growth of cancerous cells, whether administered12 orally, intravenously, or by injection.13 (b) "Health benefit plan" shall have the same meaning as provided in14 section 41-5903, Idaho Code.15 (2) A health benefit plan covering food and drug administration-ap-16 proved anticancer medications shall ensure that either:17 (a) The copayment, deductible, or coinsurance amount for prescribed18 orally administered anticancer medication is not higher than that for19 an injected or intravenously administered anticancer medication; or20 (b) Out-of-pocket costs to a covered person for an orally administered21 anticancer medication do not exceed two hundred fifty dollars ($250)22 per thirty (30) day supply.23 (3) A health benefit plan covering an anticancer medication is not re-24 quired to classify the anticancer medication as a medical benefit.25 (4) A health benefit plan that provides coverage of anticancer medica-26 tions shall not be considered in compliance with the provisions of subsec-27 tion (2) of this section by:28 (a) Increasing the copayment, deductible, or coinsurance amount re-29 quired for an anticancer medication covered under the health benefit30 plan; or31 (b) Reclassifying benefits with respect to anticancer medications.32
SECTION 2. An emergency existing therefor, which emergency is hereby33 declared to exist, this act shall be in full force and effect on and after34 July 1, 2026.35
LATEST ACTION
Take bill off General Orders; referred to Business
BILL INFO
- Session
- 2026
- Chamber
- house
- Status date
- Jan 26, 2026
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