Relating to the effect of certain reductions in a health benefit plan enrollee's out-of-pocket expenses for prescription drugs that are essential health benefits on the enrollee's cost-sharing requirements.

HB 4673 requires health benefit plans, pharmacy benefit managers, and their subcontractors to apply any reduction in an enrollee's out-of-pocket expenses for covered prescription drugs (that are essential health benefits under federal law) to the enrollee's overall cost-sharing, such as deductibles or copays. This applies when the enrollee accessed the drug through prior authorization, step therapy, or the plan's appeals process - regardless of whether the plan classifies the drug as an essential health benefit. The law takes effect for plans delivered, issued, or renewed on or after January 1, 2026, with implementation beginning September 1, 2025. It directly affects enrollees with high-cost prescription drug needs and the entities managing their health plan coverage.