Reclassification of benefits with respect to cancer treatment medications

SDCL § 58-17H-51 — under UTILIZATION REVIEW AND BENEFIT DETERMINATIONS.

SDCL § 58-17H-51

A health carrier may not reclassify benefits with respect to cancer treatment medications or increase a copayment, deductible, or coinsurance amount for covered cancer treatment medications that are injected or intravenously administered unless: (1) The increase is applied generally to other medical or pharmaceutical benefits covered under the plan and is not done to circumvent § 58-17H-50 ; (2) The reclassification of benefits with respect to cancer treatment medications is done in a manner that is consistent with §§ 58-17H-50 to 58-17H-52 , inclusive; or (3) A health carrier is applying cost-sharing increases consistent with the annual increases in the cost of health care. Source: SL 2015, ch 252 , § 2, eff. Jan. 1, 2016.