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SECOND REGULAR SESSION
HOUSE BILL NO. 2726
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE APPELBAUM.
4386H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o amend chapter 376, RSMo, by adding thereto one new section relating to insurance
coverage of drugs.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto one new section, to be
2 known as section 376.2048, to read as follows:
376.2048. 1. For purposes of this section, the terms "enr ollee", "health car e
2 pr ovider", "health carrier", and "health benefit plan" shall have the same meanings
3 given to the terms in section 376.1350.
4 2. A health carrier or health benefit plan that offers or issues health benefit
5 plans that ar e deliver ed, issued for delivery , continued, or r enewed in this state on or
6 after January 1, 2027, shall not req uire an enrol lee who has receiv ed a pr escription fr om
7 his or her health car e pro vider for a particular drug covered by the health benefit plan
8 to take a differ ent drug deemed mor e appr opriate for the enrol lee's condition by the
9 health carrier or health benefit plan in order to receive coverage under the health
10 benefit plan unless the enro llee's health car e prov ider gives written appr oval for the
11 change in drugs and the change is in the inter est of the enrol lee's health.
12 3. Nothing in this section shall be construed to preven t the substitution of an
13 inter changeable biological pr oduct as described in section 338.085.
14 4. The pr ovisions of this section shall not apply to coverage of a pr escription
15 drug res tricted via a step therapy pr otocol as described in section 376.2034.
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EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.