ORE LEG Insulin Out-of-Pocket Costs


On Feb. 27, ORE LEG bill to cap cost-sharing, out-of-pocket costs.


  • ORE LEG passed bill SB1508 re insulin cost cap and quality of life (QALY) measures.
  • Amends ORE LEG 414.025, 414.065, 414.689, 414.690, 414.701, ORE INS 743A.069.
  • Bill Provisions
  • Prohibits health benefit plans from requiring enrollee to incur costs over $35 for each 30-day supply of insulin prescribed for diabetes, or $105 for each 90-day supply.
  • Prohibits Health Evidence Review Commission (HERC) from relying upon any QALY measure in determining coverage of services by the Oregon Health Plan (OHP).
  • Legislative History
  • On Feb. 5, 2024, bill was introduced in Senate; on Feb. 13, 2024, bill passed Senate.
  • On Feb. 14, 2024, bill introduced in the House; on Feb. 27, 2024, bill passed in House.
  • Effectiveness
  • Act takes effect on Jan. 1 of year after its passage; amendments re insulin apply to health benefit plans issued, renewed, extended on or after effective date of this act.
  • Mar. 2024 ORE LEG Governor Approval
  • On Mar. 25, 2024, ORE LEG reported that bill SB 1508 was approved by governor on Mar. 20, 2024, and assigned Chapter 18; becomes effective as of Jan. 1, 2025.
  • Document dated Mar. 25, 2024, was received on Apr. 16, due to a fixed feed.

Regulators ORE LEG
Entity Types Ins
Reference Ch. 18, 3/25/2024; Bill SB 1508, 2/27/2024; Citation: ORE INS 743A; ORE LEG 414;
Functions Claims/Accelerated Benefits; Compliance; Legal; Product Administration
Countries United States of America
Category
State
Products Insurance; Insurance-Health
Regions Am
Rule Type Final
Rule Date 2/27/2024
Effective Date 1/1/2025
Rule Id 202975
Linked to N/A
Reg. Last Update 3/25/2024
Report Section US Insurance

Last substantive update on 04/19/2024