H. B. 4443
(By Delegates Perdue and Border)
[Introduced February 8, 2000; referred to the
Committee on Government Organization.]
A BILL to amend chapter thirty of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article five-a, relating to
uniform prescription drug information cards; legislative
intent; health benefit plans required to issue cards; cards to
be issued in format approved by national council for
prescription drug programs; definition of health benefit plan;
and effective date and enforcement.
Be it enacted by the Legislature of West Virginia:
That chapter thirty of the code of West Virginia, one thousand
nine hundred thirty-one, as amended, be amended by adding thereto
a new article, designated article five-a, to read as follows:
ARTICLE 5A.
UNIFORM PRESCRIPTION DRUG INFORMATION CARDS.
§30-5A-1. Legislative Intent.
It is the intent of the Legislature to lessen patient's
waiting times, decrease administrative burdens for pharmacies and
improve care to patients by minimizing confusion, eliminating
unnecessary paperwork and streamlining dispensing of prescription
products paid for by third party payors. This article should be
broadly applied and interpreted to effectuate this purpose.
§30-5A-2. Issuance of drug cards.
(a) Every health benefit plan that provides coverage for
prescription drugs or devices or administers a plan including, but
not limited to, third party administrators for self insured plans
and state administered plans, shall issue to its insureds an
encrypted card containing uniform prescription drug information as
well as identifying information in relation to the particular
consumer information. The uniform prescription drug information
card shall be in the format approved by the national council for
prescription drug programs and shall include all of the required
and conditional or situational fields and conform to the most
recent pharmacy ID card implementation guide produced by the
national council for prescription drug programs or conform to a national format acceptable to the insurance commissioner.
(b) A new uniform prescription drug information card, as
required under subsection (a) of this section shall be issued by a
health benefit plan upon enrollment and reissued upon any change in
the insured's coverage that impacts data contained on the card or
upon any change in the national council for prescription drug
programs implementation guide. Newly issued cards shall be updated
with the latest coverage information and shall conform to the
national council for prescription drug programs standards then in
effect and to the implementation guide then in use.
(c) As used in this section, "health benefit plan" means an
accident and health insurance policy or certificate; a nonprofit
hospital or medical service corporation contract; a health
maintenance organization subscriber contract; a plan provided by a
multiple employer welfare arrangement; or a plan provided by
another benefit arrangement, to the extent permitted by the
Employee Retirement Income Security Act of one thousand nine
hundred seventy-four, as amended, or by any waiver of or other
exception to that act provided under federal law or regulation.
Without limitation, "health benefit plan" does not mean any of the
following types of insurance:
(1) Accident;
(2) Credit;
(3) Disability income;
(4) Specified disease;
(5) Dental or vision;
(6) Coverage issued as a supplement to liability insurance;
(7) Medical payments under automobile or homeowners;
(8) Insurance under which benefits are payable with or
without regard to fault and this is statutorily required to be
contained in any liability policy or equivalent self-insurance; and
(9) Hospital income or indemnity.
§30-5A-3. Effective date; enforcement.
(a) This article applies to health benefit plans that are
delivered, issued for delivery or renewed on and after the first
day of April, two thousand. For purposes of this article, renewal
of a health benefit policy, contract or plan is presumed to occur
on each anniversary of the date on which coverage was first
effective on the person or persons covered by the health benefit
plan.
(b) Enforcement of this article is the responsibility of the
state insurance commissioner. The insurance commissioner shall propose rules for legislative approval in accordance with article
three, chapter twenty-nine-a necessary to effectuate this article.
No health benefit plan is permitted to conduct business in this
state if it is in violation of this article.
NOTE: The purpose of this bill is to require health benefit
plans to issue prescription cards to their respective members. The
premise behind the bill is that uniform prescription cards will
lessen patient waiting times, decrease administrative burdens for
pharmacies and improve care to patients by eliminating some
paperwork and streamlining the prescription dispension process.
This article is new; therefore, strike-throughs and
underscoring have been omitted.