HF 96: 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, inclusive of any open enrollment period, 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.

House subcommittee · named January 26, 2023

• Rep. Gary M. Mohr (R) · gary.mohr@legis.iowa.gov
• Rep. Brian Best (R)
• Rep. Megan L. Srinivas (D) · megan.srinivas@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. January 24, 2023Filed in the House and sent to the Commerce committee
2. January 26, 2023House subcommittee named: Mohr, G., Best and Srinivas
3. February 1, 2023Subcommittee recommended passing it
4. March 2, 2023Approved by the House committee
5. March 6, 2023Approved by the House committee, and given a new number: HF 626
6. March 9, 2023Withdrawn