Insights

Specialty Drug Copayment Limitation Act


On April 7, 2017, B21-0032, the Specialty Drug Copayment Limitation Act, became law. The new law restricts the amount that a health insurance plan may charge for a specialty tier drug. The plan may charge no more than $150 per month for a 30-day supply or $300 for a 90-day supply. A specialty drug for this purpose is defined as a drug prescribed for a disease or condition that affects fewer than 200,000 persons in the U.S. and has a total monthly cost of $600 or more. The law is effective for health insurance policies that provide prescription drug coverage and that are renewed or issued on or after Jan. 1, 2018.

B21-0032 »