I 

111TH CONGRESS 

1ST SESSION H. R. 2366 

To amend the Employee Retirement Income Security Act of 1974, the Public 

Health Service Act, and the Internal Revenue Code of 1986 to require 

group and individual health insurance coverage and group health plans 

to provide for coverage of oral cancer drugs on terms no less favorable 

than the coverage provided for intravenously administered anticancer 

medications. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 12, 2009 

Mr. HIGGINS introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on 

Education and Labor and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Employee Retirement Income Security Act 

of 1974, the Public Health Service Act, and the Internal 

Revenue Code of 1986 to require group and individual 

health insurance coverage and group health plans to 

provide for coverage of oral cancer drugs on terms no 

less favorable than the coverage provided for intravenously administered anticancer medications. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Cancer Drug Coverage 

3 Parity Act of 2009’’. 

4 SEC. 2. PARITY IN COVERAGE FOR ORAL CANCER DRUGS. 

5 (a) GROUP HEALTH PLANS.— 

6 (1) ERISA.— 

7 (A) The Employee Retirement Income Se8 curity Act of 1974 is amended by inserting 

9 after section 714 the following new section: 

10 ‘‘SEC. 715. PARITY IN COVERAGE FOR ORAL CANCER 

11 DRUGS. 

12 ‘‘(a) IN GENERAL.—A group health plan, and a 

13 health insurance issuer providing health insurance cov14 erage in connection with a group health plan, that provides 

15 benefits with respect to intravenously administered or in16 jected cancer medications shall provide for no less favor17 able coverage for prescribed, orally administered 

18 anticancer medication used to kill or slow the growth of 

19 cancerous cells. The coverage for such medication may be 

20 subject to annual deductibles and coinsurance provisions 

21 as may be applicable to intravenously administered or in22 jected cancer medications under the plan or coverage. 

23 Written notice of the availability of such coverage shall 

24 be delivered to participants upon enrollment and annually 

25 thereafter. 


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1 ‘‘(b) APPLICATION OF NOTICE, PROHIBITIONS, 

2 ETC.—The provisions of subsections (b), (c), (d), and 

3 (e)(2) of section 713 shall apply with respect to the cov4 erage required by subsection (a) in the same manner as 

5 they apply with respect to the coverage required under 

6 such section.’’. 

7 (B) The table of contents of such Act is 

8 amended by inserting after the item relating to 

9 section 714 the following new item: 

‘‘Sec. 715. Parity in coverage for oral cancer drugs.’’. 

10 (2) PHSA.—Title XXVII of the Public Health 

11 Service Act is amended by inserting after section 

12 2707 the following new section: 

13 ‘‘SEC. 2708. PARITY IN COVERAGE FOR ORAL CANCER 

14 DRUGS. 

15 ‘‘(a) IN GENERAL.—A group health plan, and a 

16 health insurance issuer providing health insurance cov17 erage in connection with a group health plan, that provides 

18 benefits with respect to intravenously administered or in19 jected cancer medications shall provide for no less favor20 able coverage for prescribed, orally administered 

21 anticancer medication used to kill or slow the growth of 

22 cancerous cells. The coverage for such medication may be 

23 subject to annual deductibles and coinsurance provisions 

24 as may be applicable to intravenously administered or in25 jected cancer medications under the plan or coverage. 


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1 Written notice of the availability of such coverage shall 

2 be delivered to participants upon enrollment and annually 

3 thereafter. 

4 ‘‘(b) APPLICATION OF NOTICE, PROHIBITIONS, 

5 ETC.—The provisions of subsections (b), (c), (d), and 

6 (e)(2) of section 713 of the Employee Retirement Income 

7 Security Act of 1974 shall apply with respect to the cov8 erage required by subsection (a) in the same manner as 

9 they apply with respect to the coverage required under 

10 such section.’’. 

11 (3) IRC.— 

12 (A) Subchapter B of chapter 100 of the 

13 Internal Revenue Code of 1986 is amended by 

14 adding at the end the following new section: 

15 ‘‘SEC. 9813. PARITY IN COVERAGE FOR ORAL CANCER 

16 DRUGS. 

17 ‘‘(a) IN GENERAL.—A group health plan that pro18 vides benefits with respect to intravenously administered 

19 or injected cancer medications shall provide for no less fa20 vorable coverage for prescribed, orally administered 

21 anticancer medication used to kill or slow the growth of 

22 cancerous cells. The coverage for such medication may be 

23 subject to annual deductibles and coinsurance provisions 

24 as may be applicable to intravenously administered or in25 jected cancer medications under the plan. Written notice 


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1 of the availability of such coverage shall be delivered to 

2 participants upon enrollment and annually thereafter. 

3 ‘‘(b) APPLICATION OF NOTICE, PROHIBITIONS, 

4 ETC.—The provisions of subsections (b), (c), (d), and 

5 (e)(2) of section 713 of the Employee Retirement Income 

6 Security Act of 1974 shall apply with respect to the cov7 erage required by subsection (a) in the same manner as 

8 they apply with respect to the coverage required under 

9 such section.’’. 

10 (B) The table of sections for such sub11 chapter is amended by adding at the end the 

12 following new item: 

‘‘9813. Parity in coverage for oral cancer drugs.’’. 

13 (b) INDIVIDUAL HEALTH INSURANCE COVERAGE.— 

14 Title XXVII of the Public Health Service Act is amended 

15 by inserting after section 2753 the following new section: 

16 ‘‘SEC. 2754. PARITY IN COVERAGE FOR ORAL CANCER 

17 DRUGS. 

18 ‘‘The provisions of section 2708 shall apply to health 

19 insurance coverage offered by a health insurance issuer 

20 in the individual market in the same manner as they apply 

21 to health insurance coverage offered by a health insurance 

22 issuer in connection with a group health plan in the small 

23 or large group market.’’. 

24 (c) EFFECTIVE DATE.— 


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1 (1) GROUP HEALTH PLANS.—The amendments 

2 made by subsection (a) shall apply with respect to 

3 group health plans for plan years beginning after the 

4 date that is 1 year after the date of enactment of 

5 this Act. 

6 (2) INDIVIDUAL HEALTH INSURANCE COV7 ERAGE.—The amendment made by subsection (b) 

8 shall apply with respect to health insurance coverage 

9 offered, sold, issued, renewed, in effect, or operated 

10 in the individual market after the date that is 1 year 

11 after the date of enactment of this Act. 

Æ 


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