California SB1199 regulates prescription drug cost sharing for health insurance policies and health care service plans.

California SB1199 mandates that health insurers and health care service plans count any amount paid for a covered drug toward an insured's or enrollee's cost sharing, including direct support from drug manufacturers. This applies to nongrandfathered health insurance policies and health care service plans, excluding certain exceptions like grandfathered plans and Medicare supplements. The bill also outlines exceptions for direct support from drug manufacturers under specific conditions, such as when a lower-cost generic or biosimilar is available.

California SB1199 regulates prescription drug cost sharing for health insurance policies and health care service plans.

California SB1199 mandates that health insurers and health care service plans count any amount paid for a covered drug toward an insured's or enrollee's cost sharing, including direct support from drug manufacturers. This applies to nongrandfathered health insurance policies and health care service plans, excluding certain exceptions like grandfathered plans and Medicare supplements. The bill also outlines exceptions for direct support from drug manufacturers under specific conditions, such as when a lower-cost generic or biosimilar is available.