Senate Bill No. 170

(By Senators Bailey, Caldwell and Minard)

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[Introduced February 16, 2001; referred to the Committee on Health and Human Resources; and then to the Committee on Finance.]
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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 one. 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 dispensing of prescription drugs.

This article is new; therefore, strike-throughs and underscoring have been omitted.