2018 -- S 2131

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LC003946

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2018

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A N   A C T

RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS

     Introduced By: Senators Picard, and Pearson

     Date Introduced: January 23, 2018

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-20.8 of the General Laws entitled "Prescription Drug Benefits"

is hereby amended by adding thereto the following section:

     27-20.8-3. Medication synchronization.

     (a) A health insurer, or a health maintenance organization, issuing or delivering in this

state an individual or a group health insurance policy that provides prescription drug coverage

shall offer medication synchronization to allow an insured to align at least once in a plan year the

refill dates for prescription drugs covered by the policy. The insurer or health maintenance

organization, shall implement a process for dispensing prescription drugs to an insured for the

purpose of aligning the refill dates of such drugs, and such medication synchronization may be

available only through a network pharmacy. A controlled substance, a prescription drug

dispensed in an unbreakable package, or a multi-dose unit of a prescription drug may not be

partially filled for the purpose of aligning refill dates. The insurer or health maintenance

organization, shall pay a full dispensing fee to the network pharmacy for each partial refill of a

covered prescription drug dispensed to align refill dates, unless otherwise agreed to by the plan

and the network pharmacy at the time an insured requests medication synchronization. The

insurer or health maintenance organization, shall prorate the cost sharing obligations of the

insured for each partial refill of a covered prescription drug dispensed to align refill dates. This

section applies to policies renewed or entered into, on or after January l, 2018.

     (b) Notwithstanding subsection (a) of this section, an alternate process used by an insurer

which includes early refill dates, refill overrides, and access on the insurer's or health

maintenance organization's public website to the terms and conditions of such a process is

deemed to comply with the requirements of this section.

     SECTION 2. This act shall take effect upon passage and shall apply to all insurance

policies renewed or entered into on or after January 1, 2018.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS

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     This act would require insurers to let enrollees align the refill dates for most drugs at in-

network pharmacies at least once during their insurance plan year. The insurers must prorate

patient co-payments for partial refills.

     This act would take effect upon passage and would apply to all insurance policies

renewed or entered into on or after January 1, 2018.

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