|
HOUSE OF REPRESENTATIVES |
H.B. NO. |
1117 |
|
TWENTY-NINTH LEGISLATURE, 2017 |
|
|
|
STATE OF HAWAII |
|
|
|
|
|
|
|
|
||
|
|
||
A BILL FOR AN ACT
RELATING TO WORKERS' COMPENSATION PRESCRIPTION DRUGS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Section 386-21.7, Hawaii Revised Statutes, is amended to read as follows:
"[[]§386-21.7[]]
Prescription drugs; pharmaceuticals. (a) Notwithstanding any
other provision to the contrary, immediately after a work injury is sustained
by an employee and so long as reasonably needed, the employer shall furnish to
the employee all prescription drugs as the nature of the injury requires. The
liability for the prescription drugs shall be subject to the deductible under
section 386-100.
b) Payment for all forms of prescription drugs including repackaged and relabeled drugs shall be one hundred forty per cent of the average wholesale price set by the original manufacturer of the dispensed prescription drug as identified by its National Drug Code and as published in the Red Book: Pharmacy's Fundamental Reference as of the date of dispensing, except where the employer or carrier, or any entity acting on behalf of the employer or carrier, directly contracts with the provider or the provider's assignee for a lower amount.
(c) Payment for compounded prescription drugs shall be the sum of one hundred forty per cent of the average wholesale price by gram weight of each underlying prescription drug contained in the compounded prescription drug. For compounded prescription drugs, the average wholesale price shall be that set by the original manufacturer of the underlying prescription drug as identified by its National Drug Code and as published in the Red Book: Pharmacy's Fundamental Reference as of the date of compounding, except where the employer or carrier, or any entity acting on behalf of the employer or carrier, directly contracts with the provider or provider's assignee for a lower amount. In no instance shall the prescription supply be for more than thirty days and payment shall not exceed $1,000 in a thirty day period.
(d) All pharmaceutical claims submitted for repackaged, relabeled, or compounded prescription drugs shall include the National Drug Code of the original manufacturer. If the original manufacturer of the underlying drug product used in repackaged, relabeled, or compounded prescription drugs is not provided or is unknown, then reimbursement shall be one hundred forty per cent of the average wholesale price for the original manufacturer's National Drug Code number as listed in the Red Book: Pharmacy's Fundamental Reference of the prescription drug that is most closely related to the underlying drug product.
(e) Reimbursement for any drug under schedule II of chapter 329, Uniform Controlled Substances Act, which is dispensed directly by a physician to an injured employee shall be limited to an initial thirty-day supply, commencing upon the first visit with that physician.
[(e)] (f) Notwithstanding any
other provision in this section to the contrary, equivalent generic drug
products shall be substituted for brand name pharmaceuticals unless the
prescribing physician certifies that no substitution shall be prescribed
because the injured employee's condition does not tolerate an equivalent
generic drug product.
[(f)] (g) For purposes of this
section, "equivalent generic drug product" has the same meaning as
provided in section 328-91."
SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 3. This Act, upon its approval, shall take effect on July 1, 2017.
|
INTRODUCED BY: |
_____________________________ |
|
|
BY REQUEST
|
Report Title:
Workers' Compensation; Prescription Drugs
Description:
Limits reimbursements for compounded prescription drugs to $1,000 in a thirty-day period. Limits reimbursements for any schedule II drug under chapter 329, Uniform Controlled Substances Act, Hawaii Revised Statues, dispensed by a physician to a one-time thirty-day supply upon the first visit.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.