HB415 Alabama 2016 Session

Summary

Primary Sponsor

Ron Johnson

Republican

Session

Regular Session 2016

Title

Insulin infusion, prohibit health insurance companies from requiring hospital rather than clinic

Summary

HB415 would require health plans that cover IV insulin infusion to allow clinic-based treatment and prohibit higher cost-sharing for clinic infusion.

What This Bill Does

It would require a health benefit plan that covers intravenous insulin infusion to cover the infusion in a clinic or physician's office, not only in a hospital. It would also bar higher copays, deductibles, or coinsurance for clinic infusion compared with hospital infusion, regardless of the infusion’s formulation or how the plan classifies the benefit. The bill defines terms like clinic, hospital, health benefit plan, and intravenous insulin infusion to clarify its scope and says plans cannot dodge the rule by raising costs or reclassifying benefits. It would take effect on the first day of the third month after it passes and receives governor approval.

Who It Affects

• Insured individuals in Alabama who have a health benefit plan that covers intravenous insulin infusion would be able to receive the infusion in a clinic without paying more than they would for a hospital infusion.
• Health benefit plans, insurers, clinics, and hospitals in Alabama would need to ensure clinic-based IV insulin infusion is covered and priced the same as hospital infusion, potentially changing how benefits are classified and how claims are processed.

Key Provisions

• Defines Clinic, Hospital, Health Benefit Plan, and Intravenous Insulin Infusion to set the scope of the bill.
• Requires plans that cover intravenous insulin infusion to cover the infusion when done in a clinic and prohibits higher copayment, deductible, or coinsurance for clinic infusion, regardless of formulation or benefit category.
• Prohibits plans from avoiding compliance by increasing copayment, deductible, or coinsurance amounts for intravenous insulin infusion.
• Prohibits plans from avoiding compliance by reclassifying benefits related to intravenous insulin infusion.
• Effective date: first day of the third month following passage and governor approval; applies to plans outside Alabama that process Alabama claims.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health Insurance