HB 263

As Introduced
136th General Assembly
    Regular Session  H. B. No. 263
  2025-2026
  Representatives Abdullahi, Hall, T.
  Cosponsors: Representatives Brennan, Troy, Synenberg, McNally, Sweeney,
  Rader, Baker, Cockley, Grim, White, E., Hall, D., Piccolantonio, Brewer, Brent,
  Somani, Sims, Miller, J., Brownlee, Mohamed, Lett, Isaacsohn
  A BILL
  To enact section 3902.65 of the Revised Code to cap  1
  cost sharing for prescription insulin drugs,  2
  diabetes devices, and diabetic ketoacidosis  3
  devices.  4
 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
      Section 1. That section 3902.65 of the Revised Code be  5
enacted to read as follows:  6
      Sec. 3902.65. (A) As used in this section:  7
      (1) "Prescription insulin drug" means a prescription drug  8
that contains insulin and is used to treat diabetes;  9
      (2) "Diabetes device" means a blood glucose test strip,  10
continuous glucose monitor, lancet, lancing device, insulin  11
syringe, insulin pump, or other device used to cure, diagnose,  12
mitigate, prevent, or treat diabetes or low blood sugar,  13
regardless of whether a prescription is required to dispense the  14
device.  15
      (3) "Diabetic ketoacidosis device" means a device that is  16
H. B. No. 263  Page 2
As Introduced
used to screen for or prevent diabetic ketoacidosis, regardless  17
of whether a prescription is required to dispense the device.  18
       (B) Notwithstanding section 3901.71 of the Revised Code,  19
no health plan issuer that provides coverage for prescription  20
insulin drugs, diabetes devices, or diabetic ketoacidosis  21
devices pursuant to the terms of a health benefit plan amended,  22
issued, or renewed on or after the effective date of this  23
section shall require cost sharing in excess of either of the  24
following:  25
       (1) Thirty-five dollars in aggregate for a thirty-day  26
supply of all covered prescription insulin drugs prescribed for  27
the covered person, regardless of the amount or type of insulin  28
needed to fill the covered person's prescription;  29
       (2) One hundred dollars in aggregate for a thirty-day  30
supply of all covered diabetes devices or diabetic ketoacidosis  31
devices used by the covered person.  32
       (C) The cost-sharing limitations prescribed by division  33
(B) of this section apply regardless of any deductible,  34
copayment, coinsurance, or any other cost-sharing requirement  35
that would otherwise apply to the covered person under the  36
health benefit plan.  37
       (D) This section does not prohibit a health plan issuer  38
from reducing a covered person's cost-sharing requirement for  39
prescription insulin drugs, diabetes devices, or diabetic  40
ketoacidosis devices to amounts less than those prescribed by  41
division (B) of this section.  42