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SF 3604

Patient assistance program application of funds to a deductible disclosure requirement provision

2025-2026 Regular Session Introduced by Jordan Rasmusson

Requires health insurers and patient assistance programs to disclose how pharmaceutical assistance funds apply toward insurance deductibles.

Author added Nelson
#commerceandcommercedepartment #insurance-health
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Bill Summary · SF 3604

Legislative bill overview

SF 3604 requires health insurers and patient assistance programs to disclose how patient assistance funds can be applied toward insurance deductibles. The bill establishes transparency requirements around the coordination between pharmaceutical assistance programs and health insurance cost-sharing obligations, ensuring patients understand what portion of their out-of-pocket costs these programs can cover.

Why is this important

Patients often rely on manufacturer patient assistance programs to afford medications but may be confused about whether those funds reduce their insurance deductibles or only cover copayments and coinsurance. Without clear disclosure, patients could face unexpected out-of-pocket expenses or make uninformed decisions about treatment. This transparency requirement helps patients make better healthcare decisions and understand their actual financial obligations.

Potential points of contention

  • Insurance industry concerns: Insurers and pharmacy benefit managers may argue that detailed deductible coordination disclosures create administrative burden or compete with existing cost-transparency requirements
  • Pharmaceutical manufacturer impact: Drug manufacturers' patient assistance programs may face increased compliance costs and administrative complexity in tracking how funds interact with various insurance plans
  • Implementation scope: Unclear whether the requirement applies only to in-network programs, how it handles multi-state insurers with varying deductible structures, and what constitutes adequate disclosure format

Compiled from official sources — confirm details with the bill’s official record.

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