NO COST-SHARING OF CERTAIN DRUGS
What changed between versions
Added specific eligibility criteria requiring individuals to be between ages 45-65 with intermediate cardiovascular risk as determined by a health care provider using evidence-based algorithms.
Modified coronary artery calcium screening requirements to allow coverage every five years only if the initial score is zero, and to not require future screenings if the score is greater than zero.
Added new requirements prohibiting cost sharing for generic cholesterol medications and second-line step therapy medications when generics fail to lower LDL below 60 mg/dL or cause adverse reactions.
Added comprehensive definitions for key terms including 'cholesterol lipid panels,' 'coronary artery calcium screening,' 'cost sharing,' and 'health care provider' to ensure consistent interpretation.
Added exemptions for short-term travel, accident-only, limited or specified-disease policies, catastrophic plans, and high-deductible health plans until deductibles are met.
Added new duties for the Board of Pharmacy to promulgate rules for cardiovascular risk assessment and prescribing of lipid-lowering therapies based on cardiovascular risk levels.
Modified effective date provisions to apply to policies delivered, issued, or renewed on or after January 1, 2027.
Added coverage requirements for health maintenance organizations, nonprofit health care plans, and expanded group health care plans beyond the original scope.
Removed original sponsor information and formatting elements from the introduced version, replacing with committee substitute formatting.