hb 0546

CHAPTER 286

HB 546 - FINAL VERSION

AN ACT relative to uniform prescription drug information cards.

SPONSORS: Rep. Kathleen Taylor, Straf 70

This bill requires that insurers providing coverage for prescription drugs issue to their enrollees a card or other similar item containing uniform prescription drug information.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT relative to uniform prescription drug information cards.

Be it Enacted by the Senate and House of Representatives in General Court convened:

286:1 Statement of Intent. It is the intent of the general court to improve care to patients by minimizing confusion, eliminating unnecessary paperwork, decreasing administrative burdens, and streamlining dispensing of prescription products paid for by third party payors.

286:2 New Section; Accident and Health Insurance; Individual; Prescription Drug Cards. Amend RSA 415 by inserting after section 6-j the following new section:

I. Each insurer that issues or renews any individual policy of accident or health insurance which provides coverage for prescription drugs or devices or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to certificate holders a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued and shall include, at a minimum, the following information:

(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.

(c) All of the electronic transaction routing information required by the insurer or its benefit administrator in order for the pharmacy to electronically process a prescription claim, including but not limited to the BIN number labeled as such or the Processor Control Number labeled as such, or both.

II. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph I.

III. A new uniform prescription drug information card, as required under this section, shall be issued by an insurer upon enrollment of new members and when reissuing a new card to current members when there is a change in the certificate holder's pharmacy coverage that affects data contained on the card.

286:3 New Section; Accident and Health Insurance; Group; Prescription Drug Cards. Amend RSA 415 by inserting after section 18-n the following new section:

I. Each insurer that issues or renews any policy of group or blanket accident or health insurance which provides coverage for prescription drugs or devices, or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to certificate holders a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued and shall include, at a minimum, the following information:

(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.

II. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph I.

286:4 Health Service Corporations; Prescription Drug Cards. Amend RSA 420-A:2 to read as follows:

420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:18, V, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

286:5 New Paragraphs; Managed Care; Prescription Drug Cards. Amend RSA 420-J:7-b by inserting after paragraph IV the following new paragraphs:

V. Every health benefit plan that provides coverage for prescription drugs or devices, or administers such a plan, or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to covered persons a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued and shall include, at a minimum, the following information:

(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.

VI. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph V.

VII. A new uniform prescription drug information card, as required under paragraph V, shall be issued by health benefit plan upon enrollment of new members and when reissuing a new card to current members when there is a change in the covered person's pharmacy coverage that affects data contained on the card.