Bill Text: HI SB2494 | 2014 | Regular Session | Amended
Bill Title: Motor Vehicle Insurance; Personal Injury Protection Benefits; Reimbursement; Drugs, Supplies, and Materials
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2014-02-10 - Report adopted; Passed Second Reading, as amended (SD 1) and referred to WAM. [SB2494 Detail]
Download: Hawaii-2014-SB2494-Amended.html
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THE SENATE |
S.B. NO. |
2494 |
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TWENTY-SEVENTH LEGISLATURE, 2014 |
S.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO PERSONAL INJURY PROTECTION BENEFITS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that overprescribing of prescription drugs and drug price gouging have had a growing impact on the limited personal injury protection benefits available to motorists under Hawaii's motor vehicle insurance code and ultimately, the premium levels for motor vehicle insurance in Hawaii.
Accordingly, the purpose of this Act is to ensure that personal injury protection benefits remain consistent with the prepaid health care plans in Hawaii, as required by sections 431:10C-103.5 and 431:10C-103.6, Hawaii Revised Statutes, by clearly specifying requirements for the reimbursement of drugs, supplies, and materials associated with personal injury protection benefits.
SECTION 2. Chapter 431, article 10C, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§431:10C- Personal injury protection benefits; reimbursement; drugs, supplies, and materials. For purposes of the benefits described under section 431:10C-103.5:
(1) All charges for prescribed drugs, supplies, or materials for the use of the claimant shall be separately listed and certified by the health care provider or a duly authorized representative that the charges for the drugs, supplies, or materials were required or prescribed for the injury covered by motor vehicle insurance benefits;
(2) Dietary supplements, such as minerals and vitamins, shall not be reimbursable unless a specific compensable dietary deficiency has been clinically established in the claimant as a result of the injury covered by motor vehicle insurance benefits; and
(3) Charges for covered prescription drugs and medical supplies shall not exceed amounts charged and reimbursable under prepaid health care plans, as provided under chapter 393, for those drugs and supplies covered by prepaid health care plans, unless the provider and the motor vehicle insurer have contracted or agreed to payment at a different amount; provided that:
(A) If requested by the motor vehicle insurer, the medical provider shall submit a written statement confirming the specific amounts reimbursed by prepaid health care plans for the prescription drug or product dispensed;
(B) If the drug or supply is not a drug or supply covered by prepaid health care plans, the prescribing physician shall submit a written justification supporting the need for the specific drug or supply, rather than any drug commonly allowed under prepaid health care plans;
(C) The charges submitted shall be comparable to the charge for the product covered by prepaid health care plans that most closely mirrors the properties and ingredients of the prescribed drug or the properties or component parts that most closely mirror the prescribed supply;
(D) If there are no comparable drugs or supplies, the charges submitted shall be limited to no more than one hundred twenty per cent of the wholesale price actually paid by the provider and shall not include consideration of any additional charges related to repackaging of any prescription; and
(E) Approved generics shall be substituted for brand name pharmaceuticals and supplies unless the prescribing physician certifies no substitution is permitted because the claimant's condition will not tolerate a generic preparation and the prescribing physician provides the basis to support this medical determination."
SECTION 3. New statutory material is underscored.
SECTION 4. This Act shall take effect on July 1, 2050.
Report Title:
Motor Vehicle Insurance; Personal Injury Protection Benefits; Reimbursement; Drugs, Supplies, and Materials
Description:
Ensures personal injury protection benefits remain consistent with prepaid health care plans by clearly specifying requirements for the reimbursement of drugs, supplies, and materials. Effective 07/01/2050. (SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
