HOUSE CONCURRENT RESOLUTION NO.114

(By Delegate Guthrie)

[Originating in the Committee on Banking and Insurance]

[February 28, 2014]

Requesting the Joint Committee on Government and Finance authorize a study on whether to create a statutory option for persons with health coverage to fill prescriptions through any pharmacy, without penalty in the form of higher health plan copayments or deductibles or other conditions not applied to prescriptions filled by a health plan’s designated pharmacy.

    WHEREAS, the Legislature recognizes that many health plans, including those issued by health insurers, hospital service corporations, medical service corporations, dental service corporations, health service corporations, health care corporations, and health maintenance organizations, provide coverage for prescription drugs; and

    WHEREAS, the Legislature recognizes that health plan issuers structure health plans to provide health coverage, including prescription drug coverage, at the lowest possible cost; and

    WHEREAS, the Legislature recognizes that some health plans covering prescription drugs encourage covered persons to use a designated mail-order pharmacy, which may charge the health plan less for prescription drugs, by requiring lower copayment or deductible amounts for prescriptions filled by the designated pharmacy than for prescriptions filled by other mail-order pharmacies, or by non-mail-order pharmacies even if a non-mail-order pharmacy is in the health plan’s pharmacy network; and

    WHEREAS, the Legislature recognizes that covered persons may have personal or medically necessary reasons to fill prescriptions through a pharmacy other than the health plan’s designated pharmacy; and

    WHEREAS, the Legislature recognizes that a pharmacy which has no prescription price contract with the health plan issuer may be willing to fill a prescription at the same price negotiated by the health plan issuer with its designated pharmacy; and

    WHEREAS, the Legislature recognizes that requiring a health plan to allow covered persons to use any pharmacy, without imposing a higher copayment or deductible or other condition for using a pharmacy other than the health plan’s designated pharmacy, could affect the health plan issuer’s performance of its obligations under a contract with a designated pharmacy, made pursuant to a collective bargaining agreement or otherwise, or the effectiveness of such a contract in limiting the health plan’s prescription costs; and now, therefore, be it

    Resolved by the Legislature of West Virginia:

    That the Joint Committee on Government and Finance is hereby requested to study whether health plan issuers should be required, under policies or contracts providing prescription drug coverage, to allow covered persons to fill prescriptions at any pharmacy willing to accept the same payments accepted by the health plan’s designated pharmacy, without imposing deductibles, copayments or other conditions that the health plan does not apply to prescriptions filled by the designated pharmacy; and, be it

    Further Resolved, That the Joint Committee on Government and Finance report to the regular session of the Legislature, 2015, on its findings, conclusions, and recommendations, together with drafts of any legislation necessary to effectuate its recommendations; and, be it

    Further Resolved, That the expenses necessary to conduct this study and to prepare and draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.