The bill requires a carrier that offers a health benefit plan or a
pharmacy benefit management firm that administers or manages contraception coverage under a health benefit plan to provide coverage for, and reimburse a prescribing provider or in-network dispensing entity for, the single dispensing or furnishing of an amount of contraception intended to last for 12 months' duration, as permitted by the covered person's prescription.
Further, under the bill, a carrier offering a health benefit plan or a
pharmacy benefit management firm acting on behalf of a carrier is subject to certain requirements, as applicable, including:
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Allowing coverage of continuous use of contraception, as determined by the prescribing provider;
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Prohibiting utilization management practices that prevent the dispensing of a 12-months' duration of contraception;
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Allowing for alternate prescribed contraception, if medically necessary; and
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Providing coverage for over-the-counter contraception without a prescription and without prior authorization, step therapy, utilization management, or cost sharing.
The bill also requires carriers to report annually to the division of
insurance in the department of regulatory agencies concerning contraception coverage and authorizes the commissioner of insurance to promulgate rules regarding the coverage.
