Bill Text: HI HB65 | 2013 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Prescription Drugs; Prescription Drug Benefits; Retail Community Pharmacy; Retail Pharmacy Network; Mail Order Pharmacy; Opt Out

Status: (Passed) 2013-07-02 - Act 226, on 6/27/2013 (Gov. Msg. No. 1329). [HB65 Detail]

Download: Hawaii-2013-HB65-Amended.html

HOUSE OF REPRESENTATIVES

H.B. NO.

65

TWENTY-SEVENTH LEGISLATURE, 2013

H.D. 2

STATE OF HAWAII

S.D. 1

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO PRESCRIPTION DRUGS.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  The legislature finds that many pharmacy benefit management companies and other prescription drug providers impose certain requirements, including the requirement for beneficiaries to purchase prescription drugs from a mail-order pharmacy.  This requirement can cause an inconvenience for a person who needs to purchase prescription medications and may even prevent the person from promptly obtaining urgently needed prescription medications, by requiring the person to wait for mail-order delivery.  The legislature finds that the consumer should have the choice to purchase prescription medications either from a mail-order pharmacy or from a local retail pharmacy.

     The purpose of this Act is to:

     (1)  Allow beneficiaries of prescription drug benefits providers to opt out of the requirement to purchase prescription drugs from a mail-order pharmacy and alternatively purchase prescription drugs from a retail pharmacy;

     (2)  Prohibit a pharmacy benefit management company from restricting a patient's choice of pharmacy from which to receive prescription medications;

     (3)  Prohibit a pharmacy benefit manager from manipulating the amounts of drug co-payments that it charges in a manner that would encourage beneficiaries to receive prescription medications through a mail-order pharmacy; and

     (4)  Require affected entities to submit a report to the legislature no later than twenty days prior to the convening of the regular session of 2018.

     SECTION 2.  The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter

PRescription drug benefits

     §   -1  Prescription drugs; mail order opt out option.  (a)  Individual beneficiaries enrolled in any prescription drug benefits plan within the State may opt out of a plan requirement to purchase prescriptions by mail order to alternatively purchase prescriptions drugs at a retail pharmacy.

     (b)  A pharmacy benefit management company shall not restrict a patient's choice of pharmacy from which to receive prescription medications, including requiring patients to receive prescription medications from mail-order pharmacies.

     (c)  A pharmacy benefit manager shall not manipulate the amounts of drug co-payments that it charges in a manner that would encourage beneficiaries to receive prescription medications through a mail-order pharmacy.

     §   -2  Violations; penalties.  (a)  The insurance commissioner may assess a fine of up to $10,000 for each violation upon a pharmacy benefit management company or any other provider of prescription drug benefits who is in violation of this chapter.  In addition, the insurance commissioner may direct the pharmacy benefit management company to cease and desist prohibited activity, take specific affirmative corrective action, or make restitution of money, property, or other assets.

     (b)  A pharmacy benefit management company or any prescription drug benefits provider may appeal any decision made by the insurance commissioner under this chapter, whereupon the opportunity for an administrative hearing under chapter 91 shall be afforded.  Any pharmacy benefit management company or prescription drug benefits provider aggrieved by the final decision and order shall be entitled to judicial review in accordance with chapter 91 or may submit the matter to binding arbitration."

     SECTION 3.  Chapter 87A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§87A‑     Prescription drugs; opt out option.  Individual beneficiaries enrolled in a Hawaii employer-union health benefits trust fund health benefits plan may opt out of a plan requirement to purchase prescription drugs from a mail-order pharmacy to alternatively purchase prescription drugs from a retail pharmacy."

     SECTION 4.  (a)  All entities affected by the requirements of this measure, including pharmacy benefit management companies, prescription drug benefits providers, and the Hawaii employer-health benefits trust fund, shall each submit a report to the legislature no later than twenty days prior to the convening of the regular session of 2018.

     (b)  Each individual report shall include:

     (1)  The number of subscribers, dependent beneficiaries, and employers of the entity affected by the provisions of this measure;

     (2)  The total number of subscribers, dependent beneficiaries, and employers of the entity who opted out of the requirement to purchase prescription drugs from a mail-order pharmacy; and

     (3)  The overall economic impact on the entity of the opt‑out provisions, including any increased costs to prescription drug benefits plans, increased costs to plan members or beneficiaries, or any cost savings to plan members or beneficiaries.

     SECTION 5.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 6.  New statutory material is underscored.   SECTION 7.  This Act shall take effect on July 1, 2013; provided that this Act shall be repealed on June 30, 2018.

 


 


 

Report Title:

Prescription Drugs; Prescription Drug Benefits; Mail-Order Pharmacy; Opt out

 

Description:

Allows beneficiaries of prescription drug benefits providers to opt out of the requirement to purchase prescription drugs from a mail-order pharmacy and alternatively purchase prescription drugs from a retail pharmacy.  Prohibits a pharmacy benefit management company from restricting a patient's choice of pharmacy from which to receive prescription medications.  Prohibits a pharmacy benefits manager from providing incentive copayments to members for the utilization of mail-order pharmacies.  Requires affected entities to report to the legislature prior to the regular session of 2018.  Repeals 06/30/2018.  (SD1)

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

 

 

feedback