Bill Text: IA HF2433 | 2013-2014 | 85th General Assembly | Introduced
Bill Title: A bill for an act relating to pharmacy benefits management and the use, sharing, selling, rental, leasing, and dissemination of a covered individual's health information. (Formerly HSB 629)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2014-03-14 - Referred to Judiciary. H.J. 499. [HF2433 Detail]
Download: Iowa-2013-HF2433-Introduced.html
House
File
2433
-
Introduced
HOUSE
FILE
2433
BY
COMMITTEE
ON
JUDICIARY
(SUCCESSOR
TO
HSB
629)
A
BILL
FOR
An
Act
relating
to
pharmacy
benefits
management
and
the
use,
1
sharing,
selling,
rental,
leasing,
and
dissemination
of
a
2
covered
individual’s
health
information.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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2433
Section
1.
Section
510B.1,
Code
2014,
is
amended
by
adding
1
the
following
new
subsection:
2
NEW
SUBSECTION
.
5A.
“Marketing”
means
communication
3
about
a
product
or
service
that
encourages
a
recipient
of
the
4
communication
to
purchase
or
use
the
product
or
service.
5
Sec.
2.
Section
510B.5,
Code
2014,
is
amended
to
read
as
6
follows:
7
510B.5
Contacting
covered
individual
——
using,
sharing,
8
selling,
rental,
leasing,
and
dissemination
of
covered
9
individual’s
health
information
——
requirements
——
prohibitions
.
10
1.
A
pharmacy
benefits
manager,
unless
authorized
pursuant
11
to
the
terms
of
its
contract
with
a
covered
entity
and
then
12
only
for
health
or
safety
reasons
,
shall
not
contact
any
13
covered
individual
without
the
express
written
permission
of
14
the
covered
entity
and
the
covered
individual
.
15
2.
A
pharmacy
benefits
manager
shall
not
do
any
of
the
16
following:
17
a.
Use
a
covered
individual’s
health
information
or
share
18
a
covered
individual’s
health
information
with
any
pharmacy
19
affiliated
with
or
owned,
wholly
or
in
part,
by
the
pharmacy
20
benefits
manager
for
any
purpose
including
marketing,
unless
21
all
of
the
following
conditions
are
met:
22
(1)
Use
of
the
covered
individual’s
health
information
is
23
medically
necessary
for
the
health
and
safety
of
the
covered
24
individual.
25
(2)
Use
of
the
covered
individual’s
health
information
26
is
consistent
with
regulations
promulgated
by
the
centers
27
for
Medicare
and
Medicaid
services
of
the
United
States
28
department
of
health
and
human
services,
if
such
regulations
29
are
applicable
to
the
covered
entity
and
covered
individual.
30
(3)
The
covered
individual
provides
express
written
31
permission
for
such
use
of
the
information.
32
b.
Sell,
rent,
lease,
or
disseminate
a
covered
individual’s
33
health
information
unless
the
sale,
rental,
leasing,
or
34
dissemination
complies
with
all
applicable
federal
and
35
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3
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state
laws
and
the
pharmacy
benefits
manager
has
received
1
express
written
permission
for
such
sale,
rental,
leasing,
2
or
dissemination
from
the
covered
entity
and
the
covered
3
individual.
A
pharmacy
benefits
manager
shall
provide
each
4
covered
individual
with
an
opportunity
to
affirmatively
provide
5
express
written
permission
for
the
sale,
rental,
leasing,
or
6
dissemination
of
the
covered
individual’s
health
information
7
prior
to
entering
into
any
arrangement
for
the
sale,
rental,
8
leasing,
or
dissemination
of
such
information
to
any
other
9
entity
or
to
any
subsidiary
owned,
wholly
or
in
part,
by
the
10
pharmacy
benefits
manager.
11
3.
This
section
shall
not
be
interpreted
to
prohibit
the
12
use
of
a
covered
individual’s
health
information
in
conjunction
13
with
a
covered
entity’s
program
to
more
effectively
use
14
prescription
drugs
to
improve
the
health
and
safety
of
the
15
covered
individual.
16
EXPLANATION
17
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
18
the
explanation’s
substance
by
the
members
of
the
general
assembly.
19
This
bill
relates
to
pharmacy
benefits
management.
20
The
bill
amends
provisions
relating
to
the
contacting
of
21
covered
individuals
to
include
provisions
relating
to
the
22
sharing
of
health
information
and
marketing
practices.
23
Currently,
a
pharmacy
benefits
manager
is
prohibited
from
24
contacting
a
covered
individual,
unless
authorized
pursuant
to
25
the
terms
of
its
contract
with
a
covered
entity,
without
the
26
express
written
permission
of
the
covered
entity.
The
bill
27
provides
that
in
addition
to
these
limitations,
the
pharmacy
28
benefits
manager
may
only
contact
the
covered
individual
for
29
health
or
safety
reasons
and
only
with
the
express
written
30
permission
of
the
covered
individual.
31
The
bill
prohibits
a
pharmacy
benefits
manager
from
using
a
32
covered
individual’s
health
information
or
sharing
a
covered
33
individual’s
health
information
with
any
pharmacy
affiliated
34
with
or
owned,
wholly
or
in
part,
by
the
pharmacy
benefits
35
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2433
manager
for
any
purpose,
including
marketing,
unless
use
of
1
the
covered
individual’s
health
information
is
medically
2
necessary
for
the
health
and
safety
of
the
covered
individual;
3
is
consistent
with
regulations
promulgated
by
the
centers
4
for
Medicare
and
Medicaid
services
of
the
United
States
5
department
of
health
and
human
services,
if
such
regulations
6
are
applicable
to
the
covered
entity
and
covered
individual;
7
and
if
the
covered
individual
has
provided
express
written
8
permission
for
such
use
of
the
information.
9
With
regard
to
the
selling,
rental,
leasing,
or
10
dissemination
of
a
covered
individual’s
health
information,
11
the
bill
prohibits
a
pharmacy
benefits
manager
from
selling,
12
renting,
leasing,
or
disseminating
such
information
unless
13
the
sale,
rental,
leasing,
or
dissemination
complies
with
all
14
applicable
federal
and
state
laws
and
the
pharmacy
benefits
15
manager
has
received
express
written
permission
for
such
sale,
16
rental,
leasing,
or
dissemination
from
the
covered
entity
17
and
the
individual.
A
pharmacy
benefits
manager
is
required
18
to
provide
each
covered
individual
with
an
opportunity
to
19
affirmatively
provide
express
written
permission
for
the
sale,
20
rental,
leasing,
or
dissemination
of
the
covered
individual’s
21
health
information
prior
to
the
pharmacy
benefits
manager
22
entering
into
any
arrangement
for
the
sale,
rental,
leasing,
or
23
dissemination
of
such
information
to
any
other
entity
or
to
any
24
subsidiary
owned,
wholly
or
in
part,
by
the
pharmacy
benefits
25
manager.
26
The
bill
is
not
to
be
interpreted
to
prohibit
the
use
of
27
a
covered
individual’s
health
information
in
conjunction
28
with
a
covered
entity’s
program
to
more
effectively
use
29
prescription
drugs
to
improve
the
health
and
safety
of
the
30
covered
individual.
31
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