Health insurance; modification of prescription drug coverage. (SB947)

Introduced By

Sen. Toddy Puller (D-Mount Vernon) with support from co-patron Del. Keith Hodges (R-Urbanna)

Description

Health insurance; modification of prescription drug coverage. Prohibits a health insurer, corporation providing accident and sickness subscription contracts, or health maintenance organization from making certain modifications in prescription drug coverage unless (i) the modification occurs at the time of coverage renewal; (ii) the modification is effective on a uniform basis among all policyholders, contract holders, or subscribers of identical or substantially identical policies, contracts, or plans; and (iii) the insurer, corporation, or health maintenance organization notifies affected insureds, subscribers, or members of the modification not later than 60 days before the date the modification is effective. The requirement applies only to modifications that remove a drug from a formulary, add a prior authorization requirement, impose or alter a quantity limit for a drug, impose a step-therapy restriction for a drug, or move a drug to a higher cost-sharing tier. The measure applies only to policies, contracts, or plans that include coverage for prescription drugs and utilize a formulary. Read the Bill »

Status

01/28/2013: Merged into SB945

History