Bill Text: HI HB706 | 2018 | Regular Session | Introduced
Bill Title: Relating To Workers' Compensation.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2017-11-30 - Carried over to 2018 Regular Session. [HB706 Detail]
Download: Hawaii-2018-HB706-Introduced.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
706 |
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TWENTY-NINTH LEGISLATURE, 2017 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to workers' compensation.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The purpose of this Act is to amend Act 231, Session Laws of 2014, which enacted a new section of law to curtail the alarming cost increases in prescription drugs and compounds authorized for reimbursement under the State's workers' compensation law. Since the law was enacted, further analysis of other states shows that, of the thirty-seven states that reimburse prescription drugs on the basis of a percentage of average wholesale price, the reimbursement range is great. Of note, Hawaii has the highest reimbursement rate for brand name and generic drugs, at average wholesale price plus forty per cent. The next highest state is Louisiana, at average wholesale price plus ten per cent with a $10.51 dispensing fee for brand name drugs. The national average for brand name drugs is average wholesale price minus three per cent, with a $4.32 dispensing fee, and for generic drugs, the national average is minus four per cent, with a $4.94 dispensing fee. More specifically, California reimburses at a rate of minus seventeen per cent with a $7.25 dispensing fee for both brand name and generic drugs. Oregon reimburses at a rate of minus 16.5 per cent with a $2.00 dispensing fee for both brand name and generic drugs. Both these states are considered progressive workers' compensation states and have worked on their systems extensively.
The purpose of this Act is to bring Hawaii closer to the rest of the nation in terms of its reimbursement for prescription drugs and compounds.
SECTION 2. Section 386-21.7, Hawaii Revised Statutes, is amended to read as follows:
"[[]§386-21.7[]] Prescription
drugs; pharmaceuticals. (a) Notwithstanding any other provision to
the contrary, immediately after a work injury is sustained by an employee and
so long as reasonably needed, the employer shall furnish to the employee all
prescription drugs as the nature of the injury requires. The liability for the
prescription drugs shall be subject to the deductible under section 386-100.
(b) Payment for all forms of prescription
drugs including repackaged and relabeled drugs shall be [one hundred forty]
minus ten per cent of the average wholesale price set by the original
manufacturer of the dispensed prescription drug as identified by its National
Drug Code and as published in the Red Book: Pharmacy's Fundamental Reference
as of the date of dispensing, except where the employer or carrier, or any
entity acting on behalf of the employer or carrier, directly contracts with the
provider or the provider's assignee for a lower amount.
(c) Payment for compounded prescription drugs
shall be the sum of [one hundred forty] minus ten per cent of the
average wholesale price by gram weight of each underlying prescription drug
contained in the compounded prescription drug. For compounded prescription
drugs, the average wholesale price shall be that set by the original
manufacturer of the underlying prescription drug as identified by its National
Drug Code and as published in the Red Book: Pharmacy's Fundamental Reference
as of the date of compounding, except where the employer or carrier, or any
entity acting on behalf of the employer or carrier, directly contracts with the
provider or provider's assignee for a lower amount.
(d) All pharmaceutical claims submitted for
repackaged, relabeled, or compounded prescription drugs shall include the
National Drug Code of the original manufacturer. If the original manufacturer
of the underlying drug product used in repackaged, relabeled, or compounded
prescription drugs is not provided or is unknown, then reimbursement shall be [one
hundred forty] minus ten per cent of the average wholesale price for
the original manufacturer's National Drug Code number as listed in the Red
Book: Pharmacy's Fundamental Reference of the prescription drug that is most
closely related to the underlying drug product.
(e) Notwithstanding any other provision in this section to the contrary, equivalent generic drug products shall be substituted for brand name pharmaceuticals unless the prescribing physician certifies that no substitution shall be prescribed because the injured employee's condition does not tolerate an equivalent generic drug product.
(f) Physician dispensed prescription drugs may only be prescribed during the first ninety days from the date of injury.
[(f)] (g) For purposes of this
section, "equivalent generic drug product" has the same meaning as
provided in section 328-91."
SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 4. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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Report Title:
Workers' Compensation; Prescription Drugs
Description:
Adjusts the payment for workers' compensation prescription drugs from 140% to -10% of the average wholesale price.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
