2012 -- H 7327

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LC00905

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2012

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A N A C T

RELATING TO INSURANCE - ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Representatives Corvese, Ajello, Handy, Walsh, and Malik

     Date Introduced: February 02, 2012

     Referred To: House Corporations

It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

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Insurance Policies" is hereby amended by adding thereto the following section:

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     27-18-71. Coverage for prescription drugs. – (a) Every individual or group health

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insurance contract, or every individual or group hospital or medical expense insurance policy,

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plan, or group policy issued for delivery, or renewed in this state on or after the passage of this

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act that provides coverage for prescription drugs shall not require an insured to use, prior to using

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a brand name prescription drug prescribed by a licensed prescriber, any alternative brand name

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prescription drug or over-the-counter drugs.

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     (b) Health insurance contracts, plans or policies to which this section applies may require

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an insured to use, prior to using a brand name prescription drug prescribed by a licensed

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prescriber, a therapeutically equivalent generic drug, unless, pursuant to sections 5-19.1-19, 5-37-

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18.1 and 21-31-15(b), the prescriber indicates “brand name necessary” on the prescription form,

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or if the prescriber gives oral directions to that effect to the dispensing pharmacist.

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     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-19-62. Coverage for prescription drugs. – (a) Every individual or group health

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insurance contract, or every individual or group hospital or medical expense insurance policy,

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plan, or group policy issued for delivery, or renewed in this state on or after the passage of this

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act that provides coverage for prescription drugs shall not require an insured to use, prior to using

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a brand name prescription drug prescribed by a licensed prescriber, any alternative brand name

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prescription drug or over-the-counter drugs.

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     (b) Health insurance contracts, plans or policies to which this section applies may require

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an insured to use, prior to using a brand name prescription drug prescribed by a licensed

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prescriber, a therapeutically equivalent generic drug, unless, pursuant to sections 5-19.1-19, 5-37-

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18.1 and 21-31-15(b), the prescriber indicates “brand name necessary” on the prescription form,

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or if the prescriber gives oral directions to that effect to the dispensing pharmacist.

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     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-20-57. Coverage for prescription drugs. -- (a) Every individual or group health

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insurance contract, or every individual or group hospital or medical expense insurance policy,

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plan, or group policy issued for delivery, or renewed in this state on or after the passage of this

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act that provides coverage for prescription drugs shall not require an insured to use, prior to using

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a brand name prescription drug prescribed by a licensed prescriber, any alternative brand name

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prescription drug or over-the-counter drugs.

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     (b) Health insurance contracts, plans or policies to which this section applies may require

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an insured to use, prior to using a brand name prescription drug prescribed by a licensed

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prescriber, a therapeutically equivalent generic drug, unless, pursuant to sections 5-19.1-19, 5-37-

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18.1 and 21-31-15(b), the prescriber indicates “brand name necessary” on the prescription form,

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or if the prescriber gives oral directions to that effect to the dispensing pharmacist.

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     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

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Organizations" is hereby amended by adding thereto the following section:

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     27-41-75. Coverage for prescription drugs. -- (a) Every individual or group health

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insurance contract, or every individual or group hospital or medical expense insurance policy,

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plan, or group policy issued for delivery, or renewed in this state on or after the passage of this

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act that provides coverage for prescription drugs shall not require an insured to use, prior to using

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a brand name prescription drug prescribed by a licensed prescriber, any alternative brand name

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prescription drug or over-the-counter drugs.

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     (b) Health insurance contracts, plans or policies to which this section applies may require

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an insured to use, prior to using a brand name prescription drug prescribed by a licensed

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prescriber, a therapeutically equivalent generic drug, unless, pursuant to sections 5-19.1-19, 5-37-

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18.1 and 21-31-15(b), the prescriber indicates “brand name necessary” on the prescription form,

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or if the prescriber gives oral directions to that effect to the dispensing pharmacist.

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     SECTION 5. This act shall take effect upon passage.

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LC00905

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO INSURANCE - ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would prevent health or accident and sickness insurance policies, plans or

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contracts that provide coverage for prescription drugs from requiring a beneficiary to use an

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alternative brand name prescription drug or over-the-counter drug prior to using a brand name

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prescription drug prescribed by a licensed physician.

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     This act would take effect upon passage.

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LC00905

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