Bill Text: HI SB1453 | 2011 | Regular Session | Amended
Bill Title: Insurance; Prior Authorization; Prescription Medication; Working Group
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Engrossed - Dead) 2011-03-24 - (H) Report adopted; referred to the committee(s) on FIN with none voting no and Har, Riviere, Wooley excused. [SB1453 Detail]
Download: Hawaii-2011-SB1453-Amended.html
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THE SENATE |
S.B. NO. |
1453 |
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TWENTY-SIXTH LEGISLATURE, 2011 |
S.D. 2 |
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STATE OF HAWAII |
H.D. 1 |
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A BILL FOR AN ACT
RELATING TO PRESCRIPTION MEDICATIONS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that prior authorization for prescription medications requires that physicians obtain approval from a health insurance carrier to prescribe a specific medication for their patients. Without this prior authorization, a health insurance carrier may not provide coverage for patient medication. Despite its growing visibility and importance, the prior authorization process is not standardized across insurers and providers and is often conducted without the benefit of communications technology, thereby creating unnecessary administrative burdens and costs to health care providers and health insurers. The current process also results in delays in filling patient prescriptions and potentially adverse health effects.
While prescription drugs requiring prior authorization constitute only a small fraction of all prescribed medications, the number of drugs requiring prior authorization and the number of prior authorizations required by insurers have grown rapidly in recent years indicating that prior authorization has become a widely used method of drug use management.
The legislature finds that the stakeholders in the issue of prior authorization for prescription medications represent important perspectives on this complex issue. Therefore, the purpose of this Act is to convene a working group of diverse stakeholders to consider the issue of prior authorization for prescription medication and make recommendations for legislative action based on consensus of the participants.
SECTION 2. (a) There is established the prescription medication prior authorization working group to consider the issue of insurers' prior authorization requirements for prescription medications and make recommendations for legislative action based on consensus of the participants. The working group shall conduct research, assess and evaluate policies for a standardized and expeditious policy for use by health care and insurance providers to obtain prior authorization for prescription medications, and make recommendations to the legislature based on best practices. The working group shall consider:
(1) The requirements of state and federal law relating to prescription medications;
(2) Preservation of patient confidentiality and compliance with the federal Health Insurance Portability and Accountability Act of 1996, Public Law No. 104-191;
(3) Incorporation of electronic prescribing and electronic health records to maximize efficiency in the prior authorization process;
(4) Current prior authorization requirements of health insurers and managed care plans currently operating in the State; and
(5) Best practices of other states that have adopted policies to standardize or coordinate prior authorization policies across health care providers and health insurers.
The working group shall submit a report of its findings and recommendations, including any implementing legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2012.
(b) The working group established pursuant to this Act shall be convened by the Healthcare Association of Hawaii, which shall provide the working group with meeting space and the support necessary to facilitate discussion, but shall not be a participating member of the working group. The working group shall include:
(1) The director of human services, or the director's designee;
(2) A representative of the Hawaii Health Information Exchange;
(3) A representative of pharmacists practicing within the State;
(4) A representative from each of the providers of accident and health or sickness insurance in this State, including health maintenance organizations;
(5) A representative of physicians practicing within the State;
(6) A representative of the consumer or patient advocacy community; and
(7) Any other members that the working group or its convener find necessary for the efficient operation of the working group.
(c) The working group shall cease to exist on December 31, 2012.
SECTION 3. This Act shall take effect on July 1, 2050.
Report Title:
Insurance; Prior Authorization; Prescription Medication; Working Group
Description:
Authorizes a working group composed of stakeholders and convened by the Healthcare Association of Hawaii to consider issues relating to prior authorization for prescription medication and to make recommendations for future legislation. Effective July 1, 2050. (SB1453 HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
