Bill Text: HI SB2436 | 2012 | Regular Session | Amended
Bill Title: Prior Authorization; Insurance; Prescription Drugs
Spectrum: Partisan Bill (Democrat 14-0)
Status: (Engrossed - Dead) 2012-03-23 - (H) Report adopted. referred to the committee(s) on FIN as amended in HD 2 with none voting aye with reservations; none voting no (0) and Herkes excused (1). [SB2436 Detail]
Download: Hawaii-2012-SB2436-Amended.html
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THE SENATE |
S.B. NO. |
2436 |
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TWENTY-SIXTH LEGISLATURE, 2012 |
S.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO PRESCRIPTION DRUG.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Article 10A of chapter 431, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§431:10A‑ Prescription drug prior authorization. (a) No later than July 1, 2013, the director of human services shall develop a uniform prior authorization form for prescription drugs. The director of human services shall consult with health care insurance providers, prescribers, and The Hawaii Pharmacists Association when developing the uniform prior authorization form, and shall take into consideration existing prior authorization forms established by the federal Centers for Medicare and Medicaid Services and national standards pertaining to electronic prior authorization.
(b) The uniform prior authorization form shall meet the following criteria:
(1) The form shall not exceed two pages;
(2) The form shall be made electronically available by the department, health care insurance providers, prescribers, and dispensers; and
(3) The completed form may be electronically submitted from prescribers to health care insurance providers.
(c) Notwithstanding any other law to the contrary, commencing January 1, 2014, health care insurance providers that provide prescription drug benefits shall accept only the uniform prior authorization form when requiring authorization for prescription drug benefits.
(d) Notwithstanding any other law to the contrary, commencing January 1, 2014, every prescriber shall use the uniform prior authorization form to request prior authorization coverage for prescription drug benefits and every health care insurance provider shall accept the form as sufficient to request prior authorization for prescription drug benefits.
(e) If a health care insurance provider fails to utilize or accept the uniform prior authorization form, or fails to respond within two business days upon receipt of a completed uniform prior authorization request from a prescriber, the prior authorization request shall be deemed to have been granted.
(f) For the purposes of this section:
"Department" means the department of human services.
"Dispenser" means a practitioner who dispenses.
"Health care insurance provider" means any insurance company, fraternal benefit society, health care service plan, health maintenance organization, or any other entity delivering or issuing accident and health or sickness insurance, as defined in section 431:1-205.
"Prescriber" means any physician, dentist, dispenser, hospital, or other person or institution licensed and registered in this State to issue a prescription.
(g) The department may adopt rules pursuant to chapter 91 to effectuate the purpose of this section."
SECTION 2. New statutory material is underscored.
SECTION 3. This Act shall take effect on July 1, 2050.
Report Title:
Prior Authorization; Insurance; Prescription Drugs
Description:
Requires the director of human services to develop a uniform prescription drug prior authorization form no later than 07/01/2013. Beginning 01/01/2014, requires the uniform prescription drug prior authorization form to be used by prescribers and health care insurance providers. Effective 7/1/50. (SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
