Amends TCA Title 8; Title 53; Title 56, Chapter 7; Title 63; Title 68 and Title 71, Chapter 5.

This bill caps the total amount that a health insurance carrier can require a covered patient with diabetes to pay for a 30-day supply of insulin at no more than $100 and requires an investigation into consumer insulin pricing. Generally present law requires that health insurance plans cover equipment, supplies, and outpatient self-management training and education when such is prescribed by a physician as medically necessary. The benefits 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 are no greater than the annual deductible and co-insurance established for all other similar benefits within that policy, program, or contract of insurance. Notwithstanding the above provision, this bill requires a health insurance carrier that provides coverage for prescription insulin drugs 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 $100 per 30-day supply of insulin, regardless of the amount or type of insulin needed to fill the covered patient's prescription. This bill states that it does not prevent a health insurance carrier from reducing a covered patient's cost sharing by an amount greater than the amount specified above. This bill also requires the department of health, in cooperation with the division of consumer affairs of the office of attorney general and reporter, to investigate pricing of prescription insulin drugs made available to consumers to ensure adequate consumer protections in pricing of prescription insulin drugs and to determine whether additional consumer protections are needed. This bill requires the department and division, on or before November 1, 2021, to issue a report detailing the findings from the investigation. The department and division must present the report to the governor, commissioner of commerce and insurance, the speaker of the senate, and the speaker of the house of representatives. The report must include: (1) A summary of insulin pricing practices and variables that contribute to pricing of health insurance coverage; (2) Public policy recommendations to control and prevent overpricing of prescription insulin drugs made available to consumers in this state; (3) Recommendations for improvements to the Tennessee Consumer Protection Act of 1977; and (4) Other information the department and division find relevant to the purposes of the investigation. The cap on insulin payment will take effect on January 1, 2022. The requirement for the investigation into insulin pricing will take effect upon becoming law.