,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #fcja  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #h1 #bjbc,mr4
 ,gro?man 7= himself1 ,ms4 ,bonamici1   
,mr4 ,bilirakis1 ,mr4 ,higg9s ( ,new    
,york1 ,mr4 ,fitzpatrick1 ,mr4 ,morelle1
 & ,ms4 ,matsui7 introduc$ ! foll[+     
bill2 :i* 0 ref]r$ to ! ,committee on   
,education & ! ,work=ce  ,a ,,bill  ,to 
am5d ! ,employee ,retirem5t ,income     
,security ,act ( #aigd to require a gr\p
 heal? plan 7or heal? insurance cov]age 
(f]$ 9 connection ) su* a plan7 to      
provide = co/-%>+ = oral anticanc] drugs
 on t]ms no less favorable ?an ! co/-%>+
 provid$ = anticanc] m$ications adm9i/]$
 by a heal? c>e provid]4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,canc]  
,drug ,p>ity ,act ( #bjbc4  #b4 ,p>ity 9
 co/-%>+ = oral anticanc] drugs  7a7 ,9 
g5]al ,! ,employee ,retirem5t ,income   
,security ,act ( #aigd is am5d$ by      
ins]t+ aft] section #gbe ( su* ,act 7#bi
 ,u4,s4,c4 #aahe;d7 ! foll[+ new        
section3  #gbf4 ,p>ity 9 co/-%>+ = oral 

anticanc] drugs  7a7 ,9 g5]al ,subject  
to subsection 7b71 a gr\p heal? plan 7or
 heal? insurance cov]age (f]$ 9         
connection ) su* a plan7 t provides     
b5efits ) respect to anticanc]          
m$ications adm9i/]$ by a heal? c>e      
provid] %all provide t any co/-%>+ =    
prescrib$1 pati5t-adm9i/]$ anticanc]    
m$ications t are us$ to kill1 sl[1 or   
prev5t ! gr[? ( canc]\s cells & t h be5 
approv$ by ! ,food & ,drug ,adm9i/ration
 is no less favorable ?an ! co/-%>+ =   
anticanc] m$ications t is intrav5\sly   
adm9i/]$ or inject$ by a heal? c>e      
provid]4  7b7 ,limitation ,subsection   
7a7 %all only apply to an anticanc]     
m$ication t is prescrib$ bas$ on a f9d+ 
by ! treat+ physician t ! m$ication--   
7#a7 is m$ically necess>y = ! purpose ( 
kill+1 sl[+1 or prev5t+ ! gr[? ( canc]\s
 cells2 or  7#b7 is cl9ically           
appropriate 9 t]ms ( type1 frequ5cy1    
ext5t site1 & duration4  7c7 ,re/riction
 on c]ta9 *anges ,a gr\p heal? plan 7or 
heal? insurance cov]age (f]$ 9          

connection ) su* a plan7 may n1 9 ord]  
to comply ) ! requirem5t ( subsection   
7a71 make *anges to b5efits or replace  
exi/+ b5efits ) new b5efits "u ! plan   
7or heal? insurance cov]age7 design$ to 
h ! effect (-- 7#a7 impos+ an increase 9
 out-(-pocket co/s ) respect to         
anticanc] m$ications2  7#b7 reclassify+ 
b5efits ) respect to anticanc]          
m$ications 9 a way t w\ld increase su*  
co/s2 or  7#c7 apply+ m re/rictive      
limitations on prescrib$ orally adm9i/]$
 anticanc] m$ications ?an on intrav5\sly
 adm9i/]$ or inject$ anticanc]          
m$ications4  7d7 ,con/ruction ,no?+ 9   
?is section %all be con/ru$-- 7#a7 to   
require ! use ( orally adm9i/]$         
anticanc] m$ications z a replacem5t =   
o!r anticanc] m$ications2  7#b7 to      
prohibit a gr\p heal? plan 7or heal?    
insurance cov]age (f]$ 9 connection )   
su* a plan7 f requir+ prior au?orization
 or impos+ o!r appropriate utilization  
controls 9 approv+ cov]age = any        
*emo!rapy2 or  7#c7 to sup]s$e a ,/ate  

law t provides great] protections )     
respect to ! cov]age ) respect to orally
 adm9i/]$ anticanc] m$ications ?an is   
provid$ "u ?is section4  7e7 ,co/-,%>+  
def9$ ,9 ?is section1 ! t]m co/-%>+     
includes a d$uctible1 co9surance1       
copaym5t1 & any maximum limitation on ! 
application ( su* a d$uctible1          
co9surance1 copaym5t1 & simil>          
out-(-pocket exp5ses4  4  7b7 ,te*nical 
,correction2 ,cl]ical ,*ange ,! table ( 
cont5ts 9 section #a ( ! ,employee      
,retirem5t ,income ,security ,act (     
#aigd 7#bi ,u4,s4,c4 #ajja et seq47 is  
am5d$ by ins]t+ aft] ! item relat+ to   
section #gbe ! foll[+ new item3  ,sec4  
#gbf4 ,p>ity 9 co/-%>+ = oral anticanc] 
drugs4  4  7c7 ,effective date ,!       
am5dm5ts made by ?is section %all apply 
) respect to plan ye>s beg9n+ on or aft]
 ,janu>y #a1 #bjbd4  #c4 ,,gao /udy ,n  
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ?is ,act1 ! ,comptroll] ,g5]al ( !    
,unit$ ,/ates %all-- 7#a7 complete a    
/udy t assesses ! impact ( section #gbf 

( ! ,employee ,retirem5t ,income        
,security ,act ( #aigd1 z add$ by       
section #b7;a71 on ! out-(-pocket co/s  
associat$ ) oral & pati5t-adm9i/]$      
anticanc] m$ications furni%$ or disp5s$ 
to individuals enroll$ 9 a gr\p heal?   
plan to :i* su* section #gbf applies1 9 
comp>ison to individuals enroll$ 9 gr\p 
heal? plans or heal? insurance cov]age  
to :i* section #gbf does n apply1       
includ+ any recomm5dations or matt]s =  
congressional consid]ation reg>d+       
actions ,f$]al ag5cies or ,congress c   
take to r$uce f9ancial b>ri]s to access 
to oral & pati5t-adm9i/]$ anticanc]     
m$ications2 &  7#b7 submit to ,congress 
a report on ! results ( su* /udy1       
includ+ recomm5dations or matt]s =      
congressional consid]ation to improve   
access to oral & pati5t-adm9i/]$        
anticanc] m$ications = individuals      
enroll$ 9 gr\p heal? plans & gr\p or    
individual heal? insurance cov]age (f]$ 
by a heal? insurance issu]4