Fiscal Summary

Increase State Expenditures – $185,500/FY24-25 and Subsequent Years Increase Federal Expenditures – $20,100/FY24-25 and Subsequent Years Increase Local Expenditures – $33,000/FY24-25 and Subsequent Years*

Bill Summary

Under present law, the benefits required relative to equipment, supplies, and outpatient services for diabetic patients may be subject to the annual deductible and co-insurance established for all other similar benefits within a given policy, program, or contract of insurance, so long as the annual deductible and co-insurance for the benefits required are no greater than the annual deductible and co-insurance established for all other similar benefits within that policy, program, or contract of insurance.

This bill requires a health insurance carrier that provides coverage for prescription insulin drugs pursuant to the terms of a policy, program, or contract of insurance to cap the total amount that a covered patient with diabetes is required to pay for covered prescription insulin drugs at an amount not to exceed $35 per 30-day supply of insulin, regardless of the amount, type, or number of insulins or the number of prescriptions needed to complete the 30-day supply for the covered patient with diabetes. This applies to any state or local insurance program and any manage care organization contracting with the state to provide insurance through the TennCare program.

Further, this bill requires any insulin supplier that supplies prescription insulin drugs into or within this state for use by a patient with diabetes to cap the total price for prescription insulin drugs at an amount not to exceed $35 per 30-day supply of insulin, regardless of the amount, type, or number of insulins or the number of prescriptions needed to complete the 30-day supply for a patient with diabetes.