H. B. 2366


(By Delegates Border and Perdue)

[Introduced January 17, 2003 ; referred to the

Committee on Banking and Insurance then Finance.]





A BILL to amend article four, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, by adding thereto a new section, designated section twenty-one, relating to requiring health benefit plans to issue uniform prescription drug information cards or technology; requiring issuance of a uniform prescription drug information card or technology; providing enforcement authority to the insurance commissioner; requiring the insurance commissioner to propose rules for legislative approval; and prohibiting the conduct of business by health benefit plans violating this section.

Be it enacted by the Legislature of West Virginia:
That article four, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended by adding thereto a new section, designated section twenty-one, to read as follows:
ARTICLE 4. GENERAL PROVISIONS.
§33-4-21. Uniform prescription drug information card or technology.

(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, excluding the medicaid program, shall issue to its insureds a card or other technology containing prescription drug information. The uniform prescription drug information card or technology may be in a format approved by the national council for prescription drug programs and may include all of the required fields and conform to the most recent pharmacy identification card or technology implementation guide produced by the national council for prescription drug programs and shall conform to a national format approved by the insurance commissioner. If a health care plan includes a conditional or situational field, it shall conform to a pharmacy information card or technology implementation guide form which has been recommended by the national council for prescription drug programs and approved by the insurance commissioner.
(b) A new uniform prescription drug information card or technology, as required under subsection (a) of this section, shall be issued by an insurer upon enrollment and revised upon any change in the certificate holder's coverage that impacts data contained on the card. The prescription drug information card or technology shall conform to a national council prescription card or technology format approved by the insurance commissioner.
(c) For purposes of this section, a "health benefit plan" is a health insurance policy, including a self-insured health plan, that covers hospital, medical or surgical expenses, health maintenance organizations, preferred provider organizations, medical service organizations, physician-hospital organizations or any other person, firm, corporation, joint venture or other similar business entity that pays for, purchases or furnishes health care services to patients, insureds or beneficiaries in this state. The term does not include accident-only, specified disease, individual hospital indemnity, credit, dental-only, medicare-supplement, long-term care or disability income insurance; coverage issued as a supplement to liability insurance, workers' compensation or similar insurance; or automobile medical-payment insurance. For the purposes of this section, a health benefit plan located or domiciled outside of West Virginia is subject to the provisions of this section if it receives, processes, adjudicates, pays or denies claims for health care services submitted by or on behalf of patients, insureds or beneficiaries who reside in West Virginia.
(d) Enforcement of this section is the responsibility of the insurance commissioner. The insurance commissioner shall propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code that are necessary to effectuate this section. A health benefit plan may not conduct business in this state if the plan violates this section.
(e) For purposes of this section, 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.
(f) The provisions of this section shall apply to any policy, contract or plan delivered after the first day of July, two thousand three.



NOTE: The purpose of this bill is to require health benefit plans to issue uniform prescription drug information cards or technology.

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