Bill Text: AZ SB1288 | 2015 | Fifty-second Legislature 1st Regular | Introduced
Bill Title: Prescription drug coverage; medication synchronization
Spectrum: Bipartisan Bill
Status: (Passed) 2015-04-01 - Chapter 159 [SB1288 Detail]
Download: Arizona-2015-SB1288-Introduced.html
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REFERENCE TITLE: prescription drug coverage; medication synchronization |
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State of Arizona Senate Fifty-second Legislature First Regular Session 2015
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SB 1288 |
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Introduced by Senators Yee, Begay, Dalessandro, Hobbs, Lesko, Pancrazi: Allen, Barto, Bradley, Burges, Cajero Bedford, Farley, Ward
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AN ACT
Amending Title 20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20-848; Amending Title 20, chapter 4, article 9, Arizona Revised Statutes, by adding section 20-1057.15; amending Title 20, chapter 6, article 4, Arizona Revised Statutes, by adding section 20-1376.07; amending Title 20, chapter 6, article 5, Arizona Revised Statutes, by adding section 20-1406.07; relating to prescription drug benefits.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-848, to read:
20-848. Prescriptions; cost sharing; refills; dispensing fees; definition
A. A subscription contract that is issued or renewed on or after January 1, 2016 and that provides coverage for prescription drugs:
1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the contract that is dispensed by a network pharmacy for less than the standard refill amount if:
(a) The prescribing provider or pharmacist determines that filling or refilling the prescription is in the best interest of the subscriber.
(b) The subscriber requests or agrees to less than the standard refill amount for the purpose of synchronizing the subscriber's medications.
2. Shall allow a pharmacy to override a denial code related to an early refill if the prescription drug is being dispensed as part of a medication synchronization program.
3. Shall pay a full pharmacy dispensing fee for each prescription drug dispensed and may not prorate a dispensing fee, regardless of whether either of the following applies:
(a) The prescription drug is partially filled or refilled.
(b) The subscriber's copayment or fee paid for medication synchronization services is prorated.
B. For the purposes of this section, "medication synchronization" means the coordination of medication refills for a patient taking two or more medications for a chronic condition so that the patient's medications are refilled on the same schedule for a given time period.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.15, to read:
20-1057.15. Prescriptions; cost sharing; refills; dispensing fees; definition
A. An evidence of coverage that is issued or renewed on or after January 1, 2016 and that provides coverage for prescription drugs:
1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the evidence of coverage that is dispensed by a network pharmacy for less than the standard refill amount if:
(a) The prescribing provider or pharmacist determines that filling or refilling the prescription is in the best interest of the enrollee.
(b) The enrollee requests or agrees to less than the standard refill amount for the purpose of synchronizing the enrollee's medications.
2. Shall allow a pharmacy to override a denial code related to an early refill if the prescription drug is being dispensed as part of a medication synchronization program.
3. Shall pay a full pharmacy dispensing fee for each prescription drug dispensed and may not prorate a dispensing fee, regardless of whether either of the following applies:
(a) The prescription drug is partially filled or refilled.
(b) The enrollee's copayment or fee paid for medication synchronization services is prorated.
B. For the purposes of this section, "medication synchronization" means the coordination of medication refills for a patient taking two or more medications for a chronic condition so that the patient's medications are refilled on the same schedule for a given time period.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1376.07, to read:
20-1376.07. Prescriptions; cost sharing; refills; dispensing fees; definition
A. A disability insurance policy that is issued or renewed on or after January 1, 2016 and that provides coverage for prescription drugs:
1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the policy that is dispensed by a network pharmacy for less than the standard refill amount if:
(a) The prescribing provider or pharmacist determines that filling or refilling the prescription is in the best interest of the insured.
(b) The insured requests or agrees to less than the standard refill amount for the purpose of synchronizing the insured's medications.
2. Shall allow a pharmacy to override a denial code related to an early refill if the prescription drug is being dispensed as part of a medication synchronization program.
3. Shall pay a full pharmacy dispensing fee for each prescription drug dispensed and may not prorate a dispensing fee, regardless of whether either of the following applies:
(a) The prescription drug is partially filled or refilled.
(b) The insured's copayment or fee paid for medication synchronization services is prorated.
B. For the purposes of this section, "medication synchronization" means the coordination of medication refills for a patient taking two or more medications for a chronic condition so that the patient's medications are refilled on the same schedule for a given time period.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding section 20-1406.07, to read:
20-1406.07. Prescriptions; cost sharing; refills; dispensing fees
A. A group or blanket disability insurance contract that is issued or renewed on or after January 1, 2016 and that provides coverage for prescription drugs:
1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the contract that is dispensed by a network pharmacy for less than the standard refill amount if:
(a) The prescribing provider or pharmacist determines that filling or refilling the prescription is in the best interest of the insured.
(b) The insured requests or agrees to less than the standard refill amount for the purpose of synchronizing the insured's medications.
2. Shall allow a pharmacy to override a denial code related to an early refill if the prescription drug is being dispensed as part of a medication synchronization program.
3. Shall pay a full pharmacy dispensing fee for each prescription drug dispensed and may not prorate a dispensing fee, regardless of whether either of the following applies:
(a) The prescription drug is partially filled or refilled.
(b) The insured's copayment or fee paid for medication synchronization services is prorated.
B. For the purposes of this section, "medication synchronization" means the coordination of medication refills for a patient taking two or more medications for a chronic condition so that the patient's medications are refilled on the same schedule for a given time period.
