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HOUSE OF REPRESENTATIVES |
H.B. NO. |
1741 |
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TWENTY-SIXTH LEGISLATURE, 2012 |
H.D. 2 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO PRESCRIPTION DRUG.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part I of article 10A to be appropriately designated and to read as follows:
"§431:10A‑ Prescription drug prior authorization; diabetes; cancer. (a) No later than July 1, 2013, the commissioner shall develop a uniform prior authorization form for prescription drugs that are prescribed for the purpose of treating diabetes or any form of cancer. The commissioner shall consult with health care insurance providers, prescribers, advanced practice registered nurses, physician assistants, and the pharmacy association when developing the uniform prior authorization form and shall take into consideration existing prior authorization forms established by the federal Centers for Medicare and Medicaid Services and national standards pertaining to electronic prior authorization.
(b) The uniform prior authorization form shall meet the following criteria:
(1) The form shall be made electronically available by the commissioner, health care insurance providers, prescribers, and dispensers; and
(2) The completed form may be electronically submitted from prescribers to health care insurance providers.
(c) With respect to prescription drugs that are prescribed for the purpose of treating diabetes or any form of cancer:
(1) Commencing January 1, 2014, health care insurance providers that provide prescription drug benefits shall accept only the uniform prior authorization form when requiring authorization for prescription drug benefits; and
(2) Commencing January 1, 2014, every prescriber shall use the uniform prior authorization form to request prior authorization coverage for prescription drug benefits, and every health care insurance provider shall accept the form as a sufficient means of requesting prior authorization for prescription drug benefits.
(d) If a health care insurance provider fails to use or accept the uniform prior authorization form, or fails to respond within seventy-two hours upon receipt of a completed uniform prior authorization form request from a prescriber, the prior authorization request shall be deemed to have been granted.
(e) The department of commerce and consumer affairs may adopt rules pursuant to chapter 91 to effectuate this section.
(f) As used in this section:
"Dispenser" means any person authorized to dispense drugs in the State in accordance with section 329-1.
"Prescriber" means any physician, dentist, dispenser, hospital, or other person or institution licensed and registered in this State to issue a prescription."
SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article 1 to be appropriately designated and to read as follows:
"§432:1‑ Prescription drug prior authorization; diabetes; cancer. (a) No later than July 1, 2013, the commissioner shall develop a uniform prior authorization form for prescription drugs that are prescribed for the purpose of treating diabetes or any form of cancer. The commissioner shall consult with health care insurance providers, prescribers, advanced practice registered nurses, physician assistants, and the pharmacy association when developing the uniform prior authorization form and shall take into consideration existing prior authorization forms established by the federal Centers for Medicare and Medicaid Services and national standards pertaining to electronic prior authorization.
(b) The uniform prior authorization form shall meet the following criteria:
(1) The form shall be made electronically available by the commissioner, health care insurance providers, prescribers, and dispensers; and
(2) The completed form may be electronically submitted from prescribers to health care insurance providers.
(c) With respect to prescription drugs that are prescribed for the purpose of treating diabetes or any form of cancer:
(1) Commencing January 1, 2014, mutual benefit societies that provide prescription drug benefits shall accept only the uniform prior authorization form when requiring authorization for prescription drug benefits; and
(2) Commencing January 1, 2014, every prescriber shall use the uniform prior authorization form to request prior authorization coverage for prescription drug benefits, and every mutual benefit society shall accept the form as a sufficient means of requesting prior authorization for prescription drug benefits.
(d) If a mutual benefit society fails to use or accept the uniform prior authorization form, or fails to respond within seventy-two hours upon receipt of a completed uniform prior authorization form request from a prescriber, the prior authorization request shall be deemed to have been granted.
(e) The department of commerce and consumer affairs may adopt rules pursuant to chapter 91 to effectuate this section.
(f) As used in this section:
"Dispenser" means any person authorized to dispense drugs in the State in accordance with section 329-1.
"Prescriber" means any physician, dentist, dispenser, hospital, or other person or institution licensed and registered in this State to issue a prescription."
SECTION 3. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A- , 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-125, 431:10A-126, and 431:10A-122, and chapter 431M."
SECTION 4. New statutory material is underscored.
SECTION 5. This Act shall take effect on July 1, 2050; provided that on July 1, 2017, this Act shall be repealed and section 432D-23, Hawaii Revised Statutes, shall be reenacted in the form in which it read on the day prior to the effective date of this Act.
Report Title:
Prior Authorization; Insurance; Prescription Drugs
Description:
Requires the Insurance Commissioner to develop a uniform prescription drug prior authorization form no later than July 1, 2013, for only prescription drugs for the treatment of diabetes or any form of cancer. Beginning January 1, 2014, requires the uniform prescription drug prior authorization form to be used by prescribers and health care insurance providers. Effective July 1, 2050, and repealed on July 1, 2017. (HB1741 HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.