Bill Text: VA HB2400 | 2017 | Regular Session | Introduced
Bill Title: Health insurance; use of drug pricing benchmark value.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2017-01-31 - Tabled in Commerce and Labor by voice vote [HB2400 Detail]
Download: Virginia-2017-HB2400-Introduced.html
Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia is amended by adding a section numbered 38.2-3407.15:4 as follows:
§38.2-3407.15:4. Use of same drug pricing benchmark value.
A. As used in this section, unless the context requires a different meaning:
"Carrier" has the same meaning ascribed thereto in subsection A of §38.2-3407.15.
"Drug pricing benchmark value" means the base price of a prescription drug from which the carrier may deviate for reimbursement purposes.
"Health benefit plan" has the same meaning ascribed thereto in subsection A of §38.2-3407.15.
"Provider" means any hospital, physician, or other person, that is authorized by statute, licensed, or certified to furnish health care services.
"Sponsor of a health plan" means (i) the employer in the case of an employer-sponsored health plan purchased by a single employer, (ii) the employee organization in the case of a health plan purchased by an employee organization, or (iii) in the case of a health plan purchased by two or more employers or jointly by one or more employers and one or more employee organizations, the association, committee, joint board of trustees, or other similar group of representatives of the parties who purchased the health plan.
B. Carriers or their intermediaries shall utilize the same drug pricing benchmark value to reimburse providers, to charge the sponsor of a health plan, and to develop premiums for a health benefit plan.
C. The Commission shall have no jurisdiction to adjudicate individual controversies arising out of this section.
