HB 364 — AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO CANCER COVERAGE.

Summary

This Act requires that individual, blanket, and group health insurance carriers cover drug treatment for the associated conditions of metastatic cancer in the same way treatment for metastatic cancer is covered. Specifically, it requires insurance companies to cover any FDA approved drug prescribed to treat the side effects of metastatic cancer treatment and prohibits insurance companies from mandating that patients first fail to respond to a different drug or prove a history of failure of such drug. Technical changes are also made to comply with the Delaware Legislative Drafting Manual.

Bill Text

• Bill Text View text Current pdf

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

This Act mandates that health insurance policies cover drugs for the treatment of associated conditions of metastatic cancer similarly to treatments for metastatic cancer itself, and removes restrictions requiring patients to fail on other drugs first.

• § 3338B

  that directly or indirectly covers the treatment of cancer shall limit or exclude coverage for a drug approved by the United States Food and Drug Administration by mandating that the insured shall first be required to fail to successfully respond to a different drug or drugs or prove a history of failure of such a different drug or drugs; → that directly or indirectly covers the treatment of cancer shall limit or exclude coverage for a drug approved by the United States Food and Drug Administration by mandating that the insured shall first be required to fail to successfully respond to a different drug or drugs or prove a history of failure of such drug or drugs;

  This change ensures that insurance cannot impose restrictions on coverage for FDA-approved cancer treatment drugs requiring patients to have failed on other drugs first.

• § 3338B

  or, in the case of other cancers, the use of the drug is supported by national clinical guidelines, national standards of care, or peer reviewed medical literature for the treatment of the cancer, or in the case of targeted therapy, the target at issue. → or in the case of other cancers, the use of the drug is supported by national clinical guidelines, national standards of care, or peer reviewed medical literature for the treatment of the cancer, or in the case of targeted therapy, the target at issue.

  This change simplifies the text without altering its legal meaning.

• § 3555B

  that directly or indirectly covers the treatment of cancer shall limit or exclude coverage for a drug approved by the United States Food and Drug Administration by mandating that the insured shall first be required to fail to successfully respond to a different drug or drugs or prove a history of failure of such a different drug or drugs; → that directly or indirectly covers the treatment of cancer shall limit or exclude coverage for a drug approved by the United States Food and Drug Administration by mandating that the insured shall first be required to fail to successfully respond to a different drug or drugs or prove a history of failure of such drug or drugs;

  This change prevents insurance policies from imposing a requirement for patients to fail on alternative treatments before receiving coverage for FDA-approved cancer drugs.

• § 3555B

  or in the case of other cancers, the use of the drug is supported by national clinical guidelines, national standards of care, or peer reviewed medical literature for the treatment of the cancer, or in the case of targeted therapy, the target at issue. → or in the case of other cancers, the use of the drug is supported by national clinical guidelines, national standards of care, or peer reviewed medical literature for the treatment of the cancer, or in the case of targeted therapy, the target at issue.

  This alteration keeps the text consistent and aids in clarity of the insurance coverage requirements.

• § 3338B

  for the treatment of the associated conditions of metastatic cancer shall limit or exclude coverage → for drugs approved by the United States Food and Drug Administration shall limit or exclude coverage

  This change specifies that associated conditions of metastatic cancer must have the same coverage provisions as cancer treatments.

• § 3555B

  for the treatment of the associated conditions of metastatic cancer shall limit or exclude coverage → for drugs approved by the United States Food and Drug Administration shall limit or exclude coverage

  This ensures consistency in coverage requirements across different types of insurance contracts.

Action History

1. August 02, 2024

   Signed by Governor

2. June 25, 2024

   Passed By Senate. Votes: 21 YES

3. June 18, 2024

   Reported Out of Committee (Banking, Business, Insurance & Technology) in Senate with 1 Favorable, 5 On Its Merits

4. June 11, 2024

   Assigned to Banking, Business, Insurance & Technology Committee in Senate

5. June 11, 2024

   Passed By House. Votes: 39 YES 2 ABSENT

6. April 16, 2024

   Reported Out of Committee (Economic Development/Banking/Insurance & Commerce) in House with 5 Favorable, 4 On Its Merits

7. April 11, 2024

   Introduced and Assigned to Economic Development/Banking/Insurance & Commerce Committee in House

Sponsors

• David P. Sokola · Primary
• Madinah Wilson-Anton · Primary
• Eric Morrison · Primary
• Spiros Mantzavinos · Primary
• Russell Huxtable · Primary
• Timothy D. Dukes · Primary
• William J. Carson · Primary
• Nicole Poore · Primary
• William Bush · Primary
• Cyndie Romer · Primary
• Sherry Dorsey Walker · Primary
• Paul S. Baumbach · Primary
• Peter C. Schwartzkopf · Primary

Votes

Subjects