[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2366 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 2366
To amend the Employee Retirement Income Security Act of 1974, the
Public Health Service Act, and the Internal Revenue Code of 1986 to
require group and individual health insurance coverage and group health
plans to provide for coverage of oral cancer drugs on terms no less
favorable than the coverage provided for intravenously administered
anticancer medications.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 12, 2009
Mr. Higgins introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committees on
Education and Labor and Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Employee Retirement Income Security Act of 1974, the
Public Health Service Act, and the Internal Revenue Code of 1986 to
require group and individual health insurance coverage and group health
plans to provide for coverage of oral cancer drugs on terms no less
favorable than the coverage provided for intravenously administered
anticancer medications.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Cancer Drug Coverage Parity Act of
2009''.
SEC. 2. PARITY IN COVERAGE FOR ORAL CANCER DRUGS.
(a) Group Health Plans.--
(1) ERISA.--
(A) The Employee Retirement Income Security Act of
1974 is amended by inserting after section 714 the
following new section:
``SEC. 715. PARITY IN COVERAGE FOR ORAL CANCER DRUGS.
``(a) In General.--A group health plan, and a health insurance
issuer providing health insurance coverage in connection with a group
health plan, that provides benefits with respect to intravenously
administered or injected cancer medications shall provide for no less
favorable coverage for prescribed, orally administered anticancer
medication used to kill or slow the growth of cancerous cells. The
coverage for such medication may be subject to annual deductibles and
coinsurance provisions as may be applicable to intravenously
administered or injected cancer medications under the plan or coverage.
Written notice of the availability of such coverage shall be delivered
to participants upon enrollment and annually thereafter.
``(b) Application of Notice, Prohibitions, etc.--The provisions of
subsections (b), (c), (d), and (e)(2) of section 713 shall apply with
respect to the coverage required by subsection (a) in the same manner
as they apply with respect to the coverage required under such
section.''.
(B) The table of contents of such Act is amended by
inserting after the item relating to section 714 the
following new item:
``Sec. 715. Parity in coverage for oral cancer drugs.''.
(2) PHSA.--Title XXVII of the Public Health Service Act is
amended by inserting after section 2707 the following new
section:
``SEC. 2708. PARITY IN COVERAGE FOR ORAL CANCER DRUGS.
``(a) In General.--A group health plan, and a health insurance
issuer providing health insurance coverage in connection with a group
health plan, that provides benefits with respect to intravenously
administered or injected cancer medications shall provide for no less
favorable coverage for prescribed, orally administered anticancer
medication used to kill or slow the growth of cancerous cells. The
coverage for such medication may be subject to annual deductibles and
coinsurance provisions as may be applicable to intravenously
administered or injected cancer medications under the plan or coverage.
Written notice of the availability of such coverage shall be delivered
to participants upon enrollment and annually thereafter.
``(b) Application of Notice, Prohibitions, etc.--The provisions of
subsections (b), (c), (d), and (e)(2) of section 713 of the Employee
Retirement Income Security Act of 1974 shall apply with respect to the
coverage required by subsection (a) in the same manner as they apply
with respect to the coverage required under such section.''.
(3) IRC.--
(A) Subchapter B of chapter 100 of the Internal
Revenue Code of 1986 is amended by adding at the end
the following new section:
``SEC. 9813. PARITY IN COVERAGE FOR ORAL CANCER DRUGS.
``(a) In General.--A group health plan that provides benefits with
respect to intravenously administered or injected cancer medications
shall provide for no less favorable coverage for prescribed, orally
administered anticancer medication used to kill or slow the growth of
cancerous cells. The coverage for such medication may be subject to
annual deductibles and coinsurance provisions as may be applicable to
intravenously administered or injected cancer medications under the
plan. Written notice of the availability of such coverage shall be
delivered to participants upon enrollment and annually thereafter.
``(b) Application of Notice, Prohibitions, etc.--The provisions of
subsections (b), (c), (d), and (e)(2) of section 713 of the Employee
Retirement Income Security Act of 1974 shall apply with respect to the
coverage required by subsection (a) in the same manner as they apply
with respect to the coverage required under such section.''.
(B) The table of sections for such subchapter is
amended by adding at the end the following new item:
``9813. Parity in coverage for oral cancer drugs.''.
(b) Individual Health Insurance Coverage.--Title XXVII of the
Public Health Service Act is amended by inserting after section 2753
the following new section:
``SEC. 2754. PARITY IN COVERAGE FOR ORAL CANCER DRUGS.
``The provisions of section 2708 shall apply to health insurance
coverage offered by a health insurance issuer in the individual market
in the same manner as they apply to health insurance coverage offered
by a health insurance issuer in connection with a group health plan in
the small or large group market.''.
(c) Effective Date.--
(1) Group health plans.--The amendments made by subsection
(a) shall apply with respect to group health plans for plan
years beginning after the date that is 1 year after the date of
enactment of this Act.
(2) Individual health insurance coverage.--The amendment
made by subsection (b) shall apply with respect to health
insurance coverage offered, sold, issued, renewed, in effect,
or operated in the individual market after the date that is 1
year after the date of enactment of this Act.
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