HOUSE BILL NO. 6366

September 07, 2022, Introduced by Reps. Rogers, Pohutsky, Stone, Breen, Pepper, Liberati, Glanville, Koleszar, Shannon, Lasinski, Clemente, Weiss, Neeley, Young, Brixie, Aiyash, Sowerby, Hood, Rabhi, Brabec, Morse, Cavanagh, Steckloff, Scott, Hope and Tyrone Carter and referred to the Committee on Rules and Competitiveness.

A bill to amend 1956 PA 218, entitled

"The insurance code of 1956,"

(MCL 500.100 to 500.8302) by adding section 3406v.

the people of the state of michigan enact:

Sec. 3406v. (1) A health insurance policy delivered, issued for delivery, or renewed in this state that provides coverage for prescription contraceptives must include coverage for all of the following:

(a) A 12-month supply of prescription contraceptives furnished or dispensed at 1 time, unless the insured requests a smaller supply or the prescriber instructs that the insured must receive a smaller supply.

(b) If covered for other prescription drugs under the health insurance policy, outpatient consultations, examinations, procedures, and medical services that are necessary to prescribe, dispense, deliver, distribute, administer, or remove a prescription contraceptive.

(c) A prescription contraceptive that the insured's prescriber determines is medically necessary for the insured.

(2) The coverage required under subsection (1) must provide coverage for the furnishing or dispensing of up to a 12-month supply of prescription contraceptives regardless of whether the insured was covered under the health insurance policy at the time the prescription contraceptive was first dispensed.

(3) Subject to subsection (4), coverage under subsection (1) may be subject to provisions of the health insurance policy that apply equally to other prescription drugs covered by the health insurance policy, including, but not limited to, required copayments, deductibles, and coinsurance.

(4) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy described in subsection (1) shall not impose utilization controls or other forms of medical management that limit the supply or coverage of a prescription contraceptive that may be dispensed or furnished by a prescriber or pharmacy to an amount that is less than a 12-month supply unless clinical trials determine that a 12-month supply is medically inappropriate.

(5) As used in this section:

(a) "Pharmacy" means that term as defined in section 17707 of the public health code, 1978 PA 368, MCL 333.17707.

(b) "Prescriber" means that term as defined in section 17708 of the public health code, 1978 PA 368, MCL 333.17708.

(c) "Prescription contraceptive" means a drug, device, or other product, including, but not limited to, a hormonal drug, whether administered orally, transdermally, or intravaginally, that requires a prescription and is approved by the United States Food and Drug Administration to prevent pregnancy.

Enacting section 1. This amendatory act applies to health insurance policies delivered, executed, issued, amended, adjusted, or renewed in this state, or outside of this state if covering residents of this state, beginning 90 days after the date this amendatory act is enacted into law.