{"data":{"id":"us-ky/krs-304.17a-172","jurisdiction":"us-ky","citation":"KRS 304.17A-172","heading":"Requirements for health benefit plans that include anticancer","body":"medications that are injected or intravenously administered by a health care\nprovider and patient-administered anticancer medications.\n(1) For purposes of this section:\n(a) \"Anticancer medications\" means drugs and biologics that are used to kill,\nslow, or prevent the growth of cancerous cells; and\n(b) \"Cost sharing\" means the cost to an individual insured under an individual or\ngroup health benefit plan according to any coverage limit,  copayment,\ncoinsurance, deductible, or other out-of-pocket expense requirements imposed\nby the plan.\n(2) A health benefit plan that covers anticancer medications that are injected or\nintravenously administered by a health care provider and patient -administered\nanticancer medications, including but not limited to those orally administered or\nself-injected, shall not require a higher copayment, deductible, or coinsurance\namount for patient-administered anticancer medications than it requires for injected\nor intravenously administered anticancer medications, regardless of the formulation\nor benefit category determination by the health benefit plan.\n(3) A health benefit plan shall not comply with subsection (2) of this section by:\n(a) Increasing the copayment, deductible, or coinsurance amount required for\ninjected or intravenously administered anticancer medications that are covered\nunder the health benefit plan; or\n(b) Reclassifying benefits with respect to anticancer medications.\n(4) Notwithstanding any provision of this section to the contrary, an individual or group\nhealth benefit plan shall be deemed to be in compliance with this section if the cost\nsharing imposed under such a policy does not exceed one hundred dollars ($100)\nper prescription fill for a thirty (30) day period.\n(5) For a health benefit plan that meets the definition of a high deductible health plan as\ndefined by 26 U.S.C. sec. 223(c)(2), to be used in conjunction with a health savings\naccount as defined by 26 U.S.C. sec. 223(d)(1), the provi sions of subsection (4) of\nthis section shall only apply after an insured's deductible has been satisfied for the\nyear.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=43957","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:46Z","sha256":"2fb65218ca138f82f95b652004b072bd33c933e463c26d3db95cd89444737bfa","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-171","next":"us-ky/krs-304.17a-173"},"notice":"GroundRules: Original legal text. Not legal advice."}