This bill requires state Medicaid programs to cover routine patient costs for items and services that are provided in connection with a qualifying clinical trial for cancer or other life-threatening conditions.
This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer.
A request for such an exception to the protocol must be granted if (1) the treatment is expected to be ineffective, (2) the treatment will cause or is likely to cause an adverse reaction to the individual, (3) the treatment is expected to decrease the individual's ability either to perform daily activities or occupational responsibilities or adhere to the treatment plan, (4) the individual is stable based on the prescription drugs already selected, or (5) there are other medical reasons that warrant withholding the treatment.
The bill requires a group health plan to implement and make readily available a clear process for an individual to request an exception to the protocol. Requests must be granted no later than three days after receipt of the request. In certain cases where the life, health, and ability of the individual are jeopardized by the protocol, the request shall be granted no later than 24 hours after receipt of the request.
This bill would provide temporary licensing reciprocity for telehealth and interstate health care treatment during national emergencies.
This bill includes certain lymphedema compression treatment items as covered durable medical equipment under Medicare. (Lymphedema is a condition of localized fluid retention and tissue swelling that is caused when the lymphatic system is damaged or blocked.)
This bill requires health plans that cover anticancer medications administered by a health care provider to provide no less favorable cost sharing for patient-administered anticancer medications.
This bill waives Medicare coinsurance requirements with respect to colorectal cancer screening tests, regardless of the code billed for a resulting diagnosis or procedure.