HF 626: Relating to continuity of care and nonmedical switching by health carriers, health benefit plans, and utilization review organizations, and including applicability provisions

What it does

This bill relates to the continuity of care for a covered person and nonmedical switching by health carriers, health benefit plans, and utilization review organizations. The bill provides that during a covered person’s eligibility under a health benefit plan, a health plan carrier, health benefit plan, or utilization review organization shall not limit or exclude coverage of a prescription drug for the covered person if the covered person is medically stable on the drug as determined by the prescribing health care professional, the drug was previously approved by the health carrier for coverage for the person, and the covered person’s prescribing health care professional has prescribed the drug for the person’s medical condition within the previous six months.

Senate subcommittee · named January 17, 2024

• Sen. Cherielynn Westrich (R) · cherielynn.westrich@legis.iowa.gov
• Sen. Mike Klimesh (R) · mike.klimesh@legis.iowa.gov
• Sen. Sarah Trone Garriott (D) · sarah.trone.garriott@legis.iowa.gov

Lobbying · 24 for, 7 against

For: Alliance for Patient Access; American Lung Association; Blank Childrens Hospital; Brain Injury Alliance of Iowa; Bristol Myers Squibb Co.; CHAIN; Easterseals Iowa; Genentech, Inc., A Member of the Roche Group; IA Mental Health Planning Council; Iowa Affiliate of the American College of Nurse-Midwives; Iowa Chapter of the National Association of Pediatric Nurse Practitioners; Iowa Developmental Disabilities Council; and 12 more

Against: Americas Health Insurance Plans (AHIP); CVS Health; Federation of Iowa Insurers; Iowa Association of Business and Industry (ABI); National Association of Benefits and Insurance Professionals-Iowa Chapter; National Federation of Independent Business (NFIB /IA); Pharmaceutical Care Management Association

In plain words

1. March 6, 2023Filed in the House
2. March 8, 2023Cost estimate (fiscal note) posted
3. March 9, 2023Passed the House, 96–0
4. March 14, 2023Sent to the Senate Health and Human Services committee
5. March 21, 2023Senate subcommittee named: Costello, Edler and Trone Garriott
6. March 29, 2023Cost estimate (fiscal note) posted
7. January 16, 2024Sent to the Senate Commerce committee
8. January 17, 2024Senate subcommittee named: Westrich, Klimesh and Trone Garriott
9. January 29, 2024Subcommittee recommended passing it
10. January 30, 2024Approved by the Senate committee
11. April 16, 2024Passed the Senate, 48–0
12. April 17, 2024Passed the House, 94–1
13. April 17, 2024Cost estimate (fiscal note) posted
14. April 23, 2024Sent to the Governor
15. May 8, 2024Signed into law