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Equal Cancer Drug Costs: Oral vs. Intravenous

New rules aim to ensure that insurance plans treat oral cancer medications the same as intravenous or injected drugs when it comes to patient out-of-pocket costs. This means your deductibles, co-insurance, or co-payments for oral anticancer drugs will not be higher than for medications administered by a healthcare provider. The act seeks to reduce financial burdens for cancer patients, improving access to necessary treatments.
Key points
Insurers cannot impose higher cost-sharing for oral cancer drugs than for intravenously administered or injected ones.
Prohibits increasing overall out-of-pocket costs for cancer medications or reclassifying benefits to circumvent new rules.
The act does not require replacing intravenous drugs with oral ones, nor does it prevent insurers from requiring prior authorization for chemotherapy.
Provisions apply to plan years beginning on or after January 1, 2022.
A study will be conducted within two years to assess the act's impact on out-of-pocket costs for oral medications.
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Additional Information
Print number: 117_S_3080
Sponsor: Sen. Smith, Tina [D-MN]
Process start date: 2021-10-27
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Summarized by: gemini-2.5-flash-preview-05-20
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

Cancer Drug Parity Act of 2021

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 117_S_3080.

Which chamber initiated this legislation?

This legislation was initiated in the Senate.

When did the legislative process begin?

The process officially started on 2021-10-27.

What are the main provisions?

Key points include:

  • Insurers cannot impose higher cost-sharing for oral cancer drugs than for intravenously administered or injected ones.
  • Prohibits increasing overall out-of-pocket costs for cancer medications or reclassifying benefits to circumvent new rules.
  • The act does not require replacing intravenous drugs with oral ones, nor does it prevent insurers from requiring prior authorization for chemotherapy.
  • Provisions apply to plan years beginning on or after January 1, 2022.
  • A study will be conducted within two years to assess the act's impact on out-of-pocket costs for oral medications.
What is the specific legal status?

The current status is Expired.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Sen. Smith, Tina [D-MN].

What is the latest detailed status?

The latest detailed status is: Introduced in Senate

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-29.

CATEGORIES

Health