H06482026 Regular Session

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.

INSURANCE

IntroducedIn CommitteeFloor VoteEnacted

Via committee: Commerce & Human Resources

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. 648 BY BUSINESS 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 issued or renewed on or after January 1, 2027,16 covering food and drug administration-approved anticancer medications17 shall ensure that coverage for prescribed orally administered anticancer18 medication is subject to the same plan design cost sharing with respect to19 copayment, coinsurance, and deductible of an injected or intravenously ad-20 ministered anticancer medication.21 (3) Nothing in this section may be interpreted to prohibit a health ben-22 efit plan from administering a formulary or preferred drug list, requiring23 prior authorization, or imposing other appropriate utilization controls in24 approving coverage for any anticancer medication.25

SECTION 2. An emergency existing therefor, which emergency is hereby26 declared to exist, this act shall be in full force and effect on and after27 July 1, 2026.28