,,ii  #aahth ,,congress  #ast ,session  
,s4 #bjci  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #ae1     
#bjbc,ms4 ,smith 7for herself1 ,mr4     
,moran1 ,ms4 ,baldwin1 ,mr4 ,blumenthal1
 ,mr4 ,brown1 ,mrs4 ,capito1 ,mrs4      
,hyde-,smith1 ,ms4 ,klobuchar1 ,mr4     
,king1 ,mr4 ,merkley1 ,ms4 ,murkowski1  
,mr4 ,murphy1 ,mr4 ,scott of ,florida1  
,mr4 ,whitehouse1 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 ,employee ,retirement ,income 
,security ,act of #aigd to require a    
group health plan 7or health insurance  
coverage offered in connection with such
 a plan7 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 #bjbc4    

#b4 ,parity in cost-sharing for oral    
anticancer drugs  7a7 ,in general ,the  
,employee ,retirement ,income ,security 
,act of #aigd is amended by inserting   
after section #gbe of such ,act 7#bi    
,u4,s4,c4 #aahe;d7 the following new    
section3  #gbf4 ,parity in cost-sharing 
for oral anticancer drugs  7a7 ,in      
general ,subject to subsection 7b71 a   
group health plan 7or health insurance  
coverage offered in connection with such
 a plan7 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  7b7 ,limitation         

,subsection 7a7 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  
7c7 ,restriction on certain changes ,a  
group health plan 7or health insurance  
coverage offered in connection with such
 a plan7 may not1 in order to comply    
with the requirement of subsection 7a71 
make changes to benefits or replace     
existing benefits with new benefits     
under the plan 7or health insurance     
coverage7 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  7d7            
,construction ,nothing in this section  
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 7or health 
insurance coverage offered in connection
 with such a plan7 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 
section4  7e7 ,cost-,sharing defined ,in
 this section1 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  7b7         
,technical ,correction2 ,clerical       
,change ,the table of contents in       
section #a of the ,employee ,retirement 
,income ,security ,act of #aigd 7#bi    
,u4,s4,c4 #ajja et seq47 is amended by  
inserting after the item relating to    
section #gbe the following new item3    
,sec4 #gbf4 ,parity in cost-sharing for 
oral anticancer drugs4  4  7c7          
,effective date ,the amendments made by 
this section shall apply with respect to
 plan years beginning on or after       
,january #a1 #bjbd4  #c4 ,,gao study    
,not later than #b years after the date 
of enactment of this ,act1 the          
,comptroller ,general of the ,united    
,states shall-- 7#a7 complete a study   
that assesses the impact of section #gbf
 of the ,employee ,retirement ,income   
,security ,act of #aigd1 as added by    
section #b7;a71 on the out-of-pocket    
costs associated with oral and          
patient-administered anticancer         

medications furnished or dispensed to   
individuals enrolled in a group health  
plan to which such section #gbf applies1
 in comparison to individuals enrolled  
in group health plans or health         
insurance coverage to which section #gbf
 does not apply1 including any          
recommendations or matters for          
congressional consideration regarding   
actions ,federal agencies or ,congress  
can take to reduce financial barriers to
 access to oral and patient-administered
 anticancer medications2 and  7#b7      
submit to ,congress a report on the     
results of such study1 including        
recommendations or matters for          
congressional consideration to improve  
access to oral and patient-administered 
anticancer medications for individuals  
enrolled in group health plans and group
 or individual health insurance coverage
 offered by a health insurance issuer4