An Act Related to Specialty Tiers in Prescription Medication Pricing

Sec. 1. 24-A MRSA §4317-A  is enacted to read:

§ 4317-A.  Specialty tier pricing

A carrier that provides coverage for prescription drugs as part of a health plan for which cost sharing, deductibles or coinsurance obligations are determined by category of prescription drugs may not impose cost sharing, deductibles or coinsurance obligations for any prescription drug that exceed the dollar amount of cost sharing, deductibles or coinsurance obligations for nonpreferred brand drugs or their equivalent for brand drugs if there is no nonpreferred brand drug category.

summary

This bill provides that a health plan covering prescription drugs may not require cost sharing, deductibles or coinsurance obligations for prescription drugs that exceed the dollar amount for nonpreferred brand drugs or for brand drugs if there is no nonpreferred brand drug category.