Struck = removed from the bill ·
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House File 2551 -H-8131 IntroducedAmend HOUSEHouse FILEFile 2551 BYas COMMITTEEfollows: ON COMMERCE (SUCCESSOR TO HF 2253) A BILL FOR An Act relating to price transparency for prescription drugs and cost-sharing calculations by carriers, and including applicability provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
TLSB 5492HV (2) 88 ko/rn H.F.
2551 Section 1.
NEW SECTION.
510D.1 Definitions.
As used in this chapter, unless the context otherwise requires:
“Commissioner”Page means3, theby commissionerstriking oflines insurance.32 through 35 and inserting:
2.<Sec.
“Dispenser”___. means the same as defined in 21 U.S.C.
§360eee(3).
3.
“Established name” means the same as defined in 21 C.F.R.
299.4.
4.
“Health benefit plan” means the same as defined in 514J.102.
5.
“Pharmaceutical drug manufacturer” or “manufacturer” means any person engaged in the business of producing, preparing, converting, processing, packaging, labeling, or distributing a prescription drug.
“Pharmaceutical drug manufacturer” or “manufacturer” does not include a wholesale distributor or a dispenser.
6.
“Prescription drug” means the same as defined in 21 U.S.C.
§360eee(12).
7.
“Wholesale acquisition cost” or “cost” means a manufacturer’s list price for a prescription drug for wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates, or reductions in price, for the most recent month for which the information is available, as reported in wholesale price guides or other publications of drug or biological pricing data.
8.
“Wholesale distributor” means the same as defined in 21 U.S.C.
§360eee(29).
Sec.
2.
510D.2510D.5 PharmaceuticalSummary drugenforcement. manufacturers —— annual report.
Each manufacturer shall provide an annual report by February 15 to the commissioner, in a format prescribed by the commissioner, that contains the current wholesale acquisition cost for each prescription drug manufactured by the manufacturer that was sold to a person in this state in the immediately preceding calendar year.
Within thirty calendar LSB 5492HV (2) 88 -1- ko/rn 1/11 H.F.
2551 days of receipt, the commissioner shall publish the information received by the commissioner on a publicly accessible internet site.
Sec.
3.
NEW SECTION.
510D.3 Wholesale acquisition cost increase —— report.
IfUpon a prescriptiondetermination drugby soldthe tocommissioner that a personmanufacturer inor thisa statemanufacturer’s agent has violated a wholesaleprovision acquisition cost of onethis hundredchapter, dollars or more for a thirty-dayrule supplyadopted andby the costcommissioner, increases forty percent or morean overorder theissued threeby preceding consecutive calendar years, or increases fifteen percent or more in the precedingcommissioner calendarunder year,this thechapter, manufacturer of the prescription drug shall file a report with the commissioner withinmay thirtydo calendarany days of the datefollowing: on which the forty or the fifteen percent increase in the cost occurs.
The report shall be in the form and manner prescribed by the commissioner and shall include all of the following information:
TheIssue establisheda namesummary order, including a brief statement of findings of fact and conclusions of law, and direct the prescriptionmanufacturer drug.or the manufacturer’s agent to cease and desist engaging in the act or practice that is in violation of the provisions of this chapter.
AllTake brandother names,affirmative genericaction names,that proprietaryin names,the andjudgment nonproprietaryof namesthe forcommissioner is necessary to ensure that the prescriptionmanufacturer drug,or asthe applicable.manufacturer’s agent complies with the requirements of this chapter.
c.
The aggregate manufacturer-level research and development costs related to the prescription drug for the most recent calendar year for which third-party independent audit data for manufacturer-level research and development costs is available.
d.
All established names, brand names, generic names, proprietary names, and nonproprietary names for each prescription drug manufactured by the manufacturer that received approval from the United States food and drug administration in the immediately preceding three consecutive calendar years.
e.
All established names, brand names, generic names, proprietary names, and nonproprietary names for each prescription drug manufactured by the manufacturer for which a patent or exclusivity expired in the immediately preceding three consecutive calendar years.
f.
A statement detailing the factor or factors that played LSB 5492HV (2) 88 -2- ko/rn 2/11 H.F.
2551 any role in the increase in cost of the prescription drug and an explanation for the factor or factors’ impact on the increase in cost of the prescription drug.
All information and data a manufacturer submits to the commissioner must be consistent in detail and quality with the information and data submitted in the manufacturer’s annual report filed with the United States securities and exchange commission on form 10-k.
3.
InformationA providedmanufacturer byor a pharmaceuticalmanufacturer’s drugagent manufacturerthat tohas thebeen commissionerissued pursuanta tosummary order under this section that may revealcontest any of the followingsummary asorder relatedby tofiling a specificrequest prescriptionfor druga orcontested classcase ofproceeding prescriptionand drugshearing shallpursuant beto consideredchapter a17A, confidential record, and bein recognizedaccordance andwith protectedrules asadopted aby tradethe secretcommissioner. pursuant to section 22.7, subsection 3:
(1) The amountmanufacturer or the manufacturermanufacturer’s chargesagent ashall specifichave healthat carrier,least specificthirty pharmacycalendar benefitdays manager,from orthe date that the summary order is issued to file a specificrequest dispenser.for a contested case proceeding and hearing.
(2)If Thea dollarcontested valuecase ofproceeding theand rebateshearing theis manufacturernot providestimely arequested specificthe healthsummary carrier,order specificshall pharmacybecome benefitfinal manager,by oroperation aof specificlaw. dispenser.
(3) The identity of a specific health carrier, specific pharmacy benefit manager, or a specific dispenser.
WithinSection sixty17A.18A calendarshall daysnot ofapply receiptto ofa thesummary informationorder pursuantissued tounder this section,section. the commissioner shall publish all nonconfidential information received by the commissioner on the same publicly accessible internet site referenced in section 510D.2.
c.
A summary order issued pursuant to this section shall remain effective from the date of issuance unless overturned by a presiding officer of a contested case hearing, or by a court following the manufacturer’s or the manufacturer’s agent’s request for judicial review of a final action by the HF2551.3297 (5) 88 -1- ko/rn 1/7 commissioner.
3.
A manufacturer or a manufacturer’s agent violating a summary order issued under this section shall be deemed in contempt of the summary order.
Upon request of the commissioner, the attorney general shall petition the district court to enforce the summary order as certified by the commissioner.
The district court shall adjudge the manufacturer or the manufacturer’s agent in contempt of the summary order if the court finds after hearing that the manufacturer or the manufacturer’s agent is not in compliance with the summary order.
The court may assess a civil penalty of not more than one thousand dollars for each day that the manufacturer or the manufacturer’s agent is in violation of the summary order and may issue further orders as the court deems appropriate.
4.___.
510D.4510D.6 Rules.Enforcement after hearing.
The commissioner shall adopt rules pursuant to chapter 17A as necessary to administer this chapter.
Sec.
5.
NEW SECTION.
510D.5 Enforcement.
The commissioner may take any action within the commissioner’s authority to enforce compliance with this chapter.
LSB 5492HV (2) 88 -3- ko/rn 3/11 H.F.
2551 Sec.
6.
NEW SECTION.
510E.1 Definitions.
As used in this chapter unless the context otherwise requires:
“Commissioner”If, meansafter a hearing pursuant to section 510D.5, the commissioner determines that a manufacturer or a manufacturer’s agent has violated a provision of insurance.this chapter, a rule adopted by the commissioner, or an order issued by the commissioner under this chapter, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon the manufacturer or the manufacturer’s agent all of the following:
a.
A copy of the commissioner’s findings.
b.
An order requiring the manufacturer or the manufacturer’s agent to cease and desist from violating the provisions of this chapter.
“CoveredThe person”commissioner meansmay thetake sameother asaffirmative definedaction that in sectionthe 514J.102.judgment of the commissioner is necessary to ensure that the manufacturer or the manufacturer’s agent complies with the requirements of this chapter.
3.The commissioner may also, at the commissioner’s discretion, order payment of a civil penalty of not more than five thousand dollars for each of the manufacturer’s or the manufacturer’s agent’s violations of this chapter.
“HealthHF2551.3297 benefit(5) plan”88 means-2- theko/rn same2/7 as3. defined in section 514J.102.
A manufacturer or a manufacturer’s agent that violates an order of the commissioner, and while such order is in effect, may, after notice and hearing and upon order of the commissioner, be subject to a civil penalty of not more than ten thousand dollars for each violation of the commissioner’s order.
A manufacturer or a manufacturer’s agent violating an order issued by the commissioner under this subsection shall be deemed in contempt of the order.
A civil penalty collected pursuant to this section shall be deposited as provided in section 505.7.
“HealthJudicial carereview professional”of meansan action of the samecommissioner asmay definedbe insought sectionby 514J.102.a manufacturer or a manufacturer’s agent pursuant to chapter 17A.
To the extent that a decision or order of the commissioner is affirmed in a judicial review proceeding, the court shall issue an order directing that the manufacturer or the manufacturer’s agent comply with the terms of the commissioner’s decision or order.
“HealthAfter carrier”the meansperiod for judicial review of an order of the samecommissioner ashas definedexpired and no petition for judicial review has been filed, upon request of the commissioner, the attorney general shall proceed in sectionthe 514J.102.district court to enforce the order of the commissioner.
The court shall issue an order directing that the manufacturer or the manufacturer’s agent comply with the terms of the commissioner’s order.
“PharmaceuticalUpon drugrequest manufacturer”of orthe “manufacturer”commissioner, meansthe anyattorney persongeneral engagedshall inpetition the businessdistrict ofcourt producing,to preparing,enforce converting,an processing,order packaging,as labeling,certified orby distributingthe acommissioner. prescription drug.
“PharmaceuticalThe drugdistrict manufacturer”court shall adjudge the manufacturer or “manufacturer”the doesmanufacturer’s notagent includein acontempt wholesaleof distributorthe commissioner’s order if the court finds after hearing that the manufacturer or athe dispenser.manufacturer’s agent is not in compliance with the commissioner’s order.
7.The court may order a civil penalty of not more than one thousand dollars per day for each day of noncompliance against the manufacturer or the manufacturer’s agent and may issue further orders as the court deems appropriate.> HF2551.3297 (5) 88 -3- ko/rn 3/7 2.
“PrescriptionPage drug”6, meansby thestriking samelines as15 definedthrough in18 21and U.S.C.inserting:
§360eee(12).<Sec.
8.___.
“Prescription drug benefit” means a health benefit plan providing for third-party payment or prepayment for prescription drugs.
9.
“Specialty drug” means a prescription drug that a health carrier has designated as a specialty drug and that has either of the following characteristics:
a.
The United States food and drug administration has designated the prescription drug an orphan drug.
b.
The manufacturer of the prescription drug or the United States food and drug administration restricts distribution of the prescription drug to a limited number of distributors.
10.
“Utilization review” means the same as defined in section 514F.7.
11.
“Utilization review organization” means the same as defined in section 514F.7.
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2551 Sec.
7.
510E.2510E.4 HealthSummary carriersenforcement. —— annual report.
EachUpon healtha carrierdetermination shallby submitthe ancommissioner annualthat reporta byhealth Februarycarrier 1or toa thehealth commissioner,carrier’s inagent thehas formviolated anda mannerprovision prescribedof bythis thechapter, commissioner,a thatrule containsadopted theby following information for the immediatelycommissioner, precedingor calendaran year,order acrossissued allby of the healthcommissioner carrier’sunder healththis benefitchapter, plansthe thatcommissioner offermay ado prescriptionany drugof benefit:the following:
TheIssue branda namesummary order, including a brief statement of findings of fact and conclusions of law, and direct the twenty-fivehealth prescriptioncarrier drugsor mostthe frequentlyhealth coveredcarrier’s byagent to cease and desist engaging in the prescriptionact drugor benefitspractice offeredthat byis in violation of the healthprovisions carrier.of this chapter.
TheTake percentother increaseaffirmative action that in annualthe spendingjudgment byof the healthcommissioner carrieris necessary to provideensure allthat prescriptionthe drughealth benefitscarrier offeredor by the health carrier.carrier’s agent complies with the requirements of this chapter.
c.
The percent increase in premiums paid by covered persons attributable to all prescription drug benefits offered by the health carrier.
d.
The percentage of specialty drugs included in all prescription drug benefits offered by the health carrier that are subject to utilization review conducted by a utilization review organization.
e.
The percent decrease in premiums paid by covered persons attributable to specialty drugs that are subject to utilization review conducted by a utilization review organization that are included in all prescription drug benefits offered by the health carrier.
Any information a health carrier provides to the commissioner pursuant to subsection 1 that may reveal any of the following shall be considered a confidential record, and be recognized and protected as a trade secret pursuant to section 22.7:
TheA identityhealth ofcarrier or a specific health benefitcarrier’s plan.agent that has been issued a summary order under this section may contest the summary order by filing a request for a contested case proceeding and hearing pursuant to chapter 17A, and in accordance with rules adopted by the commissioner.
The health carrier or the health carrier’s agent shall have at least thirty calendar days from the date that the summary order is issued to file a request for a contested case proceeding and hearing.
If a contested case proceeding and hearing is not timely requested the summary order shall become final by operation of law.
TheSection identity17A.18A ofshall thenot specificapply priceto charged by a specificsummary manufacturer,order pharmacyissued benefitunder manager,this orsection. dispenser for a specific prescription drug or class of prescription drugs.
LSBc. 5492HV (2) 88 -5- ko/rn 5/11 H.F.
2551A c.summary order issued pursuant to this section shall remain effective from the date of issuance unless overturned by a presiding officer of a contested case hearing, or by a court following the health carrier’s or the health carrier’s agent’s request for a judicial review of a final action by the commissioner.
TheHF2551.3297 dollar(5) value88 of-4- theko/rn rebates4/7 a3. specific manufacturer, a specific pharmacy benefit manager, or a specific dispenser provides to the health carrier.
3.A health carrier or a health carrier’s agent violating a summary order issued under this section shall be deemed in contempt of the summary order.
PriorUpon torequest May 1 of each calendar year, the commissionercommissioner, shall publish the nonconfidentialattorney datageneral receivedshall bypetition the commissionerdistrict pursuantcourt to thisenforce section on the samesummary publiclyorder accessibleas internetcertified siteby referencedthe incommissioner. section 510D.2.
The datadistrict court shall beadjudge aggregatedthe fromhealth allcarrier annualor reportsthe submittedhealth pursuantcarrier’s toagent subsectionin 1,contempt andof the informationsummary shallorder beif madethe availablecourt tofinds after hearing that the publichealth incarrier aor formatthe thathealth compliescarrier’s agent is not in compliance with subsectionthe 2.summary order.
The court may assess a civil penalty of not more than one thousand dollars per day against the health carrier or the health carrier’s agent for each day that the health carrier or the health carrier’s agent is in violation of the summary order, and may issue further orders as the court deems appropriate.
8.___.
510E.3510E.5 Rules.Enforcement after hearing.
The commissioner shall adopt rules pursuant to chapter 17A as necessary to administer this chapter.
Sec.
9.
NEW SECTION.
510E.4 Enforcement.
The commissioner may take any action within the commissioner’s authority to enforce compliance with this chapter.
Sec.
10.
NEW SECTION.
514M.1 Definitions.
“Carrier”If, meansafter ana entityhearing subjectpursuant to section 510E.4, the insurancecommissioner lawsdetermines andthat regulationsa health carrier or a health carrier’s agent has violated a provision of this state,chapter, a rule adopted by the commissioner, or subjectan toorder issued by the jurisdictioncommissioner ofunder this chapter, the commissioner,commissioner thatshall offersreduce atthe leastfindings oneto writing and shall issue and cause to be served upon the health plancarrier inor thisthe state.health carrier’s agent all of the following:
a.
A copy of the commissioner’s findings.
b.
An order requiring the health carrier or the health carrier’s agent to cease and desist from violating the provisions of this chapter.
“Cost-sharingThe requirement”commissioner meansmay anytake copayment, coinsurance, deductible, or other out-of-pocketaffirmative expenseaction obligationthat requiredin ofthe orjudgment on behalf of anthe enrolleecommissioner inis ordernecessary for the enrollee to receiveensure athat specificthe health carecarrier service,or includingthe ahealth prescriptioncarrier’s drug,agent coveredcomplies bywith the enrollee’srequirements healthof plan.this chapter.
The commissioner may also, at the commissioner’s discretion, order payment of a civil penalty of not more than five thousand dollars for each of the health carrier’s or the health carrier’s agent’s violations of HF2551.3297 (5) 88 -5- ko/rn 5/7 this chapter.
“Enrollee”A meanshealth carrier or a health carrier’s agent that violates an individualorder whoof the commissioner, and while such order is eligiblein toeffect, obtainmay, healthafter carenotice servicesand underhearing and upon order of the commissioner, be subject to a healthcivil plan.penalty of not more than ten thousand dollars for each violation of the commissioner’s order.
A health carrier or a health carrier’s agent violating an order issued by the commissioner under this section shall be deemed in contempt of the order.
A civil penalty collected pursuant to this subsection shall be deposited as provided in section 505.7.
“HealthJudicial carereview services”of means an itemaction orof servicethe forcommissioner themay prevention,be treatment,sought cure,by a health carrier or healinga ofhealth ancarrier’s illness,agent injury,pursuant orto physicalchapter disability.17A.
To the extent that a decision or order of the commissioner is affirmed in a judicial review proceeding, the court shall issue an order directing that the health carrier or the health carrier’s agent comply with the terms of the commissioner’s decision or order.
“HealthAfter plan”the meansperiod afor policy,judicial contract,review certificate,of oran LSBorder 5492HVof (2)the 88commissioner -6-has ko/rnexpired 6/11and H.F.no petition for judicial review has been filed, upon request of the commissioner, the attorney general shall proceed in the district court to enforce the order of the commissioner.
2551The agreementcourt offeredshall orissue issuedan byorder adirecting carrierthat tothe provide,health deliver,carrier arrangeor for,the payhealth for,carrier’s oragent reimbursecomply anywith of the coststerms of healththe carecommissioner’s services.order.
“InternalUpon Revenuerequest Code”of meansthe commissioner, the Internalattorney Revenuegeneral Codeshall petition the district court to enforce an order as definedcertified inby sectionthe 422.3.commissioner.
7.The district court shall adjudge the health carrier or the health carrier’s agent in contempt of the commissioner’s order if the court finds after hearing that the health carrier or the health carrier’s agent is not in compliance with the commissioner’s order.
“Person”The meanscourt may order a naturalcivil person,penalty corporation,of mutualnot company,more unincorporatedthan association,one partnership,thousand jointdollars venture,per limitedday liabilityfor corporation,each trust,day estate,of foundation,noncompliance not-for-profitagainst organization,the governmenthealth carrier or governmentalthe subdivision,health orcarrier’s governmentagent orand governmentalmay agency.issue further HF2551.3297 (5) 88 -6- ko/rn 6/7 orders as the court deems appropriate.> 3.
Sec.By renumbering as necessary.
11.______________________________ LUNDGREN of Dubuque HF2551.3297 (5) 88 -7- ko/rn 7/7
NEW SECTION.
514M.2 Cost-sharing calculation.
1.
A carrier shall include all cost-sharing amounts paid by an enrollee, or by another person on behalf of the enrollee, as part of the carrier’s calculation of an enrollee’s contribution to the enrollee’s applicable cost-sharing requirement.
This requirement does not apply to cost-sharing amounts paid by an enrollee, or by another person on behalf of an enrollee, for a prescription drug for which a medically appropriate A-rated generic equivalent is available to the enrollee.
2.
Subsection 1 shall not apply to a state-regulated high-deductible health plan to the extent it results in the plan’s failure to qualify as a high-deductible health plan pursuant to section 223 of the Internal Revenue Code.
Sec.
12.
NEW SECTION.
514M.3 Severability.
If the provisions of subsection 1 conflict with a federal law or regulation as applied to a specific carrier or in a specific circumstance, the provisions shall remain in full force and effect for all carriers and in all circumstances in which the federal conflict does not exist.
Sec.
13.
NEW SECTION.
514M.4 Applicability.
This chapter applies to all health plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2021.
Sec.
14.
RETROACTIVE APPLICABILITY.
1.
The section of this Act that requires a pharmaceutical LSB 5492HV (2) 88 -7- ko/rn 7/11 H.F.
2551 drug manufacturer to submit an annual report to the commissioner containing the current wholesale acquisition cost for each of the manufacturer’s prescription drugs is applicable to all manufacturers that manufactured any prescription drug that is sold to a person in this state on or after January 1, 2020.
2.
The section of this Act that requires a pharmaceutical drug manufacturer to submit a report to the commissioner containing information related to an increase in the wholesale acquisition cost of a prescription drug manufactured by the manufacturer is applicable to all manufacturers that manufactured any prescription drug that is sold to a person in this state on or after January 1, 2020.
3.
The section of this Act that requires a health carrier to submit an annual report to the commissioner related to all of the health carrier’s health benefit plans that offer a prescription drug benefit is applicable to all health benefit plans providing for third-party payment or prepayment of health or medical expenses that provide a prescription drug benefit that have been delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2020.
EXPLANATION The inclusion of this explanation does not constitute agreement with the explanation’s substance by the members of the general assembly.
This bill relates to price transparency for prescription drugs and cost-sharing calculations by carriers.
The bill requires a manufacturer to file an annual report with the commissioner of insurance (commissioner) that discloses the wholesale acquisition cost for all prescription drugs manufactured by the manufacturer that were sold to a person in this state in the immediately preceding calendar year.
“Wholesale acquisition cost” or “cost” is defined in the bill as the manufacturer’s list price for a prescription drug for wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates, or reductions LSB 5492HV (2) 88 -8- ko/rn 8/11 H.F.
2551 in price, for the most recent month for which the information is available, as reported in wholesale price guides or other publications of drug or biological pricing data.
Within 30 calendar days of receipt, the commissioner is required to publish this information from the annual reports on a publicly accessible internet site.
If a prescription drug sold to a person in this state has a cost of $100 or more for a 30-day supply and the cost increases 40 percent or more over the three preceding calendar years, or increases 15 percent or more in the preceding calendar year, the manufacturer of the prescription drug must file a report with the commissioner within 30 calendar days of the date on which the 40 or 15 percent increase in cost occurs.
This requirement is applicable to all manufacturers that manufactured prescription drugs that are sold to a person in this state on or after January 1, 2020.
The report must include the information detailed in the bill.
Certain information provided by a manufacturer, as detailed in the bill, is considered a confidential record and is required to be protected as a trade secret.
Within 60 calendar days of receipt, the commissioner is required to publish the nonconfidential information on the same publicly accessible internet site on which the manufacturer’s annual report information is published.
The bill requires each health carrier to submit an annual report by February 1 to the commissioner that contains information as detailed in the bill across all of the health carrier’s health benefit plans.
This requirement is applicable to all health benefit plans providing for third-party payment or prepayment of health or medical expenses that provide a prescription drug benefit that have been delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2020.
“Health carrier” is defined in the bill as an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, LSB 5492HV (2) 88 -9- ko/rn 9/11 H.F.
2551 including an insurance company offering sickness and accident plans, a health maintenance organization, a nonprofit health service corporation, a plan established pursuant to Code chapter 509A for public employees, or any other entity providing a plan of health insurance, health care benefits, or health care services.
Certain information provided by a health carrier, as detailed in the bill, is considered a confidential record and must be protected as a trade secret.
Prior to May 1 of each year, the commissioner must publish the nonconfidential data received by the commissioner on the same publicly accessible internet site on which the manufacturers’ information is published.
The data must be aggregated from the annual reports submitted by all health carriers.
The bill directs the commissioner to adopt rules as necessary to administer the requirements outlined in the bill and allows the commissioner to take any action within the commissioner’s authority to enforce compliance with the manufacturer and health carrier reporting requirements outlined in the bill.
The bill also requires a carrier to include all cost-sharing amounts paid by an enrollee of a health plan, or by another person on behalf of an enrollee, as part of the carrier’s calculation of an enrollee’s contribution to the enrollee’s applicable cost-sharing requirement.
“Cost-sharing requirement” is defined in the bill as any copayment, coinsurance, deductible, or other out-of-pocket expense obligation required of or on behalf of an enrollee in order for the enrollee to receive a specific health care service, including a prescription drug, covered by the enrollee’s health plan.
This requirement applies to all health plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2021.
The bill excludes state-regulated high-deductible health plans (HDHP) from the requirement if it will result in the plan not qualifying as an HDHP under section 223 of the Internal Revenue Code.
The bill also prohibits LSB 5492HV (2) 88 -10- ko/rn 10/11 H.F.
2551 application of the requirement to a carrier or a circumstance in a manner that will conflict with a federal law or a federal regulation.
LSB 5492HV (2) 88 -11- ko/rn 11/11