,,ii #aafth ,,congress #ast ,session ,s4 #gda ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ab1 #bjai,ms4 ,smith 7for herself1 ,mr4 ,moran1 ,mr4 ,murphy1 and ,mr4 ,wicker7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to require group and individual health insurance coverage and group health plans to provide for cost sharing for oral anticancer drugs on terms no less favorable than the cost sharing provided for anticancer medications administered by a health care provider4 #a4 ,short title ,this ,act may be cited as the ,cancer ,drug ,parity ,act of #bjai4 #b4 ,parity in cost sharing for oral anticancer drugs 7a7 ,requirement 7#a7 ,in general ,section #bgai;,a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ai;a7 is amended by adding at the end the following new subsection3 7e7 ,parity in cost sharing for oral anticancer drugs 7#a7 ,in general ,subject to paragraph 7#b71 a group health plan1 and a health insurance issuer offering group or individual health insurance coverage1 that provides benefits with respect to anticancer medications administered by a health care provider shall provide that any cost sharing for prescribed1 patient-administered anticancer medications that are used to kill1 slow1 or prevent the growth of cancerous cells and that have been approved by the ,food and ,drug ,administration is no less favorable than the cost sharing for anticancer medications that is intravenously administered or injected by a health care provider4 7#b7 ,limitation ,paragraph 7#a7 shall only apply to an anticancer medication that is prescribed based on a finding by the treating physician that the medication-- 7,a7 is medically necessary for the purpose of killing1 slowing1 or preventing the growth of cancerous cells2 or 7,b7 is clinically appropriate in terms of type1 frequency1 extent site1 and duration4 7#c7 ,restriction on certain changes ,a group health plan or health insurance issuer may not1 in order to comply with the requirement of paragraph 7#a71 make changes to benefits or replace existing benefits with new benefits under the plan or health insurance coverage designed to have the effect of-- 7,a7 imposing an increase in out-of-pocket costs with respect to anticancer medications2 7,b7 reclassifying benefits with respect to anticancer medications in a way that would increase such costs2 or 7,c7 applying more restrictive limitations on prescribed orally administered anticancer medications than on intravenously administered or injected anticancer medications4 7#d7 ,construction ,nothing in this subsection shall be construed-- 7,a7 to require the use of orally administered anticancer medications as a replacement for other anticancer medications2 7,b7 to prohibit a group health plan or health insurance issuer from requiring prior authorization or imposing other appropriate utilization controls in approving coverage for any chemotherapy2 or 7,c7 to supersede a ,state law that provides greater protections with respect to the coverage with respect to orally administered anticancer medications than is provided under this subsection4 7#e7 ,cost sharing defined ,in this subsection1 the term cost sharing includes a deductible1 coinsurance1 copayment1 and any maximum limitation on the application of such a deductible1 coinsurance1 copayment1 and similar out-of-pocket expenses4 4 7#b7 ,conforming amendment ,section #bgbd7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#bc7;c77 is amended by striking section #bgjd and inserting sections #bgai;,a1 #bgbe1 and #bgbf4 7b7 ,clarifying amendment regarding application to grandfathered plans ,section #abea7;a77#d77;,a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjaa7;a77#d77;,a77 is amended by adding at the end the following new clause3 7v7 ,section #bgai;,a7e7 7relating to cost sharing for oral anticancer drugs74 4 7c7 ,effective date ,the amendments made by this section shall apply with respect to group health plans for plan years beginning on or after ,january #a1 #bjbj1 and with respect to health insurance coverage offered1 sold1 issued1 renewed1 in effect1 or operated in the individual or group market on or after such date4