SB 422: Generally revise laws relating to insurance coverage relating to cancer - Montana

SB0422_X(3).pdf → SB0422_X(4).pdf · 4 edits

MODERATE

The bill was amended to clarify that insurers cannot deny coverage for prescription drugs used to treat advanced or metastatic cancer if they follow FDA approval and national guidelines. The definition of 'terminal cancer' was added, while the definition of 'associated condition' was removed. Additionally, new provisions were added to ensure state legislators and judges can remain on group health plans until they become eligible for Medicare, even if they are no longer actively employed.

Scope change

The bill's scope was narrowed slightly by removing the requirement to cover 'associated conditions' alongside cancer, but it was expanded regarding specific protections for state officials' health benefits.

REQUIREMENT

Removed the requirement for insurers to cover 'associated conditions' (symptoms or side effects) alongside advanced or metastatic cancer, focusing coverage strictly on the cancer itself.

DEFINITION

Added a new definition for 'terminal cancer' as cancer that cannot be cured and is expected to lead to death.

Removed the previous definition for 'associated condition' which covered symptoms or side effects that could jeopardize a patient's health.

ELIGIBILITY

Added specific rules allowing state legislators and judges to remain members of group health plans until they qualify for Medicare, regardless of their employment status.

SB0422_3(6).pdf → SB0422_X.pdf · 4 edits

MODERATE

This bill was converted from a draft version to an enrolled (final) version, adding a new requirement that allows spouses of retiring members to convert their group insurance policies. It also updated the bill title to clarify that it prohibits insurers from requiring specific acts related to prescription drugs for advanced cancer.

Scope change

The bill's scope expanded to include a specific provision for converting group policies upon retirement.

REQUIREMENT

Added a new requirement allowing the spouse of a retiring member to convert a group policy as provided in section 33-22-508.

DEFINITION

Clarified the definition of 'advanced or metastatic cancer' to explicitly include cancer that has progressed beyond early stages and is considered terminal.

Clarified the definition of 'terminal cancer' to mean cancer that cannot be cured with treatment and is expected to lead to death.

TECHNICAL

Updated the bill title to explicitly state that it prohibits insurers from requiring certain acts from the insured related to prescription drugs and advanced cancer.

SB0422_2(13).pdf → SB0422_3.pdf · 3 edits

MINOR

The bill was renumbered from SB 422.2 to SB 422.3 and expanded its scope to cover both advanced and metastatic cancer, whereas the previous version only covered advanced metastatic cancer. This change broadens the protection for patients by ensuring that insurers cannot impose specific drug failure requirements for a wider range of cancer diagnoses, including those that have progressed beyond early stages and are considered terminal.

Scope change

The bill's scope was expanded to include 'metastatic cancer' in addition to 'advanced metastatic cancer', thereby increasing the number of patients eligible for the new coverage protections.

SCOPE

The definition of covered cancer conditions was changed from 'advanced metastatic cancer' to 'advanced OR metastatic cancer', extending protections to patients whose cancer has spread but may not yet be classified as fully advanced.

DEFINITION

A new definition for 'terminal cancer' was added, defining it as cancer that cannot be cured with treatment and is expected to lead to death, further clarifying the conditions under which the bill applies.

REQUIREMENT

The requirement for insurers to cover prescription drugs without demanding proof of failure on other drugs was extended to apply to both advanced and metastatic cancer cases.

SB0422.002.004_combo_final-condensed(1).pdf → SB0422_2(10).pdf · 3 edits

MINOR

The bill was amended to remove the phrase 'or' from references to 'advanced or metastatic cancer,' standardizing the terminology to 'advanced metastatic cancer' throughout the document. Additionally, the bill number was updated from SB0422.002.004 to SB0422.2, and the page header was adjusted to reflect this new number.

Scope change

The scope of the cancer coverage requirement was narrowed by removing the option for 'or metastatic cancer,' limiting the specific protection to 'advanced metastatic cancer' only.

DEFINITION

The term 'advanced or metastatic cancer' was changed to 'advanced metastatic cancer' in the title and Section 1 to ensure consistent terminology.

TECHNICAL

The bill number was updated from SB0422.002.004 to SB0422.2 in the header and title.

Minor formatting adjustments were made to the page headers and line spacing.

SB0422_2(9).pdf → SB0422.002.004_combo_final-condensed.pdf · 3 edits

MINOR

The bill was amended to clarify that it covers both 'advanced' and 'metastatic' cancer, ensuring broader protection for patients. A new definition was added to explicitly include 'terminal cancer' within the scope of covered conditions. Additionally, the text was reorganized to improve readability and consistency.

Scope change

The bill's scope was expanded to explicitly include 'terminal cancer' alongside advanced and metastatic cancer, ensuring coverage for patients whose conditions are incurable and expected to lead to death.

DEFINITION

The term 'advanced metastatic cancer' was changed to 'advanced or metastatic cancer' to broaden the scope of coverage.

A new definition for 'terminal cancer' was added, defining it as cancer that cannot be cured with treatment and is expected to lead to death.

REQUIREMENT

The text was reorganized to align the definitions and requirements more clearly, ensuring consistency across the bill.

SB0422_1(4).pdf → SB0422_2.pdf · 3 edits

MINOR

The bill adds a new requirement for health insurers to cover advanced metastatic cancer drugs only if they are the most cost-effective option according to National Comprehensive Cancer Network guidelines. It also amends existing rules regarding mandatory insurance provisions for retirees, legislators, and judges, clarifying conditions under which they can remain in group plans after leaving their positions.

Scope change

The bill's scope expanded to include new coverage mandates for specific cancer treatments, while the applicability of existing group insurance continuation rules was modified for legislators and judges.

REQUIREMENT

Added a new mandate requiring insurers to cover advanced metastatic cancer drugs only if they are the most cost-effective therapy available according to National Comprehensive Cancer Network guidelines.

ELIGIBILITY

Modified eligibility rules for legislators and judges to remain in state group insurance plans after leaving office, adding specific notification requirements and restrictions on rejoining the plan.

Clarified the conditions under which surviving spouses and children can remain in group insurance plans after a member's death.

LC1934.pdf → SB0422_1.pdf · 3 edits

MINOR

The bill was renumbered from LC 1934 to SB 422.1 and updated with the correct sponsor name, E. Boldman. The document format was also updated to reflect the official Authorized Print Version.

TECHNICAL

Bill number changed from LC 1934 to SB 422.1

Sponsor name added as E. Boldman

Page headers updated to reflect the new bill number and authorized print version status

Generally revise laws relating to insurance coverage relating to cancer

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