General Assembly Raised Bill No. 15
February Session, 2010 LCO No. 121
*00121_______INS*
Referred to Committee on Insurance and Real Estate
Introduced by:
(INS)
General Assembly
Raised Bill No. 15
February Session, 2010
LCO No. 121
*00121_______INS*
Referred to Committee on Insurance and Real Estate
Introduced by:
(INS)
AN ACT CONCERNING PRESCRIPTION DRUG COPAYMENTS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 38a-510 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2011):
[(a)] No health insurance policy issued on an individual basis, whether issued by an insurance company, a hospital service corporation, a medical service corporation or a health care center, [which] that provides coverage for prescription drugs may: [require]
(1) Require any person covered under such policy to obtain prescription drugs from a mail order pharmacy as a condition of obtaining benefits for such drugs;
(2) Impose any copayment, reimbursement amount, number of days of a drug supply for which reimbursement is allowed under such policy or any other payment or condition for prescription drugs obtained from a retail pharmacy that is more restrictive than that imposed on prescription drugs obtained from a mail order pharmacy; or
(3) Impose a monetary advantage or penalty under such policy that could affect an insured's choice of pharmacies, including, but not limited to, a higher copayment, a reduction in reimbursement or promotion of one participating pharmacy over another by such methods.
[(b) The provisions of this section shall apply to any such policy delivered, issued for delivery, renewed, amended or continued in this state on or after July 1, 2005.]
Sec. 2. Section 38a-544 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2011):
[(a)] No medical benefits contract on a group basis, whether issued by an insurance company, a hospital service corporation, a medical service corporation or a health care center, [which] that provides coverage for prescription drugs may: [require]
(1) Require any person covered under such contract to obtain prescription drugs from a mail order pharmacy as a condition of obtaining benefits for such drugs;
(2) Impose any copayment, reimbursement amount, number of days of a drug supply for which reimbursement is allowed under such contract or any other payment or condition for prescription drugs obtained from a retail pharmacy that is more restrictive than that imposed on prescription drugs obtained from a mail order pharmacy; or
(3) Impose a monetary advantage or penalty under such contract that could affect an insured's choice of pharmacies, including, but not limited to, a higher copayment, a reduction in reimbursement or promotion of one participating pharmacy over another by such methods.
[(b) The provisions of this section shall apply to any such medical benefits contract delivered, issued for delivery or renewed in this state on or after July 1, 1989.]
This act shall take effect as follows and shall amend the following sections:
Section 1 January 1, 2011 38a-510
Sec. 2 January 1, 2011 38a-544
This act shall take effect as follows and shall amend the following sections:
Section 1
January 1, 2011
38a-510
Sec. 2
January 1, 2011
38a-544
Statement of Purpose:
To require any copayment required by an individual or group health insurance policy for prescription drugs to be the same regardless of whether such drugs are obtained through a retail pharmacy or through a mail order pharmacy.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]