S-3227.2          _______________________________________________

 

                                 SENATE BILL 6271

                  _______________________________________________

 

State of Washington              52nd Legislature             1992 Regular Session

 

By Senators Nelson, West, Murray, Niemi, Vognild, Johnson, L. Smith, Moore, Anderson, Stratton, Gaspard, Wojahn, Amondson and Newhouse

 

Read first time 01/23/92.  Referred to Committee on Health & Long‑Term Care.Prohibiting restrictions on use of pharmacies by health insurance policies.


     AN ACT Relating to prescription medicine insurance coverage; adding a new section to chapter 48.20 RCW; adding a new section to chapter 48.21 RCW; adding a new section to chapter 48.44 RCW; adding a new section to chapter 48.46 RCW; adding a new section to chapter 41.05 RCW; and creating a new section.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

 

     NEW SECTION.  Sec. 1.      The legislature finds that many health care insurance policies that include prescription coverage severely restrict the citizens' choice of available pharmacies.  The legislature further finds that such restrictions infringe on the citizens' right to have their prescriptions filled at the pharmacy and by the pharmacist of their choice.

 

     NEW SECTION.  Sec. 2.  A new section is added to chapter 48.20 RCW to read as follows:

     (1) Each disability insurance policy issued or renewed after November 1, 1992, that provides for payment of all or a portion of prescription costs, or reimbursement thereof, may not limit purchase of prescription medicines to a designated pharmacy nor provide for the payment of additional fees or deductibles by the covered pharmacy patient as a condition of obtaining prescription benefits from a pharmacy other than a designated pharmacy.

     (2) The policy may not prohibit a qualified provider of pharmacy services from becoming a designated provider under the provisions of such policy if the applicant pharmacy indicates a desire to be so recognized and meets all the applicable terms and conditions of the policy contract.

     (3) Any pharmacy filling prescriptions under this section agrees to provide pharmaceutical services under the same terms, including administrative, financial, and professional conditions, as those provided by the designated pharmacy.

 

     NEW SECTION.  Sec. 3.  A new section is added to chapter 48.21 RCW to read as follows:

     (1) Each group disability insurance policy issued or renewed after November 1, 1992, that provides for payment of all or a portion of prescription costs, or reimbursement thereof, may not limit purchase of prescription medicines to a designated pharmacy nor provide for the payment of additional fees or deductibles by the covered pharmacy patient as a condition of obtaining prescription benefits from a pharmacy other than a designated pharmacy.

     (2) The policy may not prohibit a qualified provider of pharmacy services from becoming a designated provider under the provisions of such policy if the applicant pharmacy indicates a desire to be so recognized and meets all the applicable terms and conditions of the policy contract.

     (3) Any pharmacy filling prescriptions under this section agrees to provide pharmaceutical services under the same terms, including administrative, financial, and professional conditions, as those provided by the designated pharmacy.

 

     NEW SECTION.  Sec. 4.  A new section is added to chapter 48.44 RCW to read as follows:

     (1) Each health care service contract issued or renewed after November 1, 1992, that provides for payment of all or a portion of prescription costs, or reimbursement thereof, may not limit purchase of prescription medicines to a designated pharmacy nor provide for the payment of additional fees or deductibles by the covered pharmacy patient as a condition of obtaining prescription benefits from a pharmacy other than a designated pharmacy.

     (2) The policy may not prohibit a qualified provider of pharmacy services from becoming a designated provider under the provisions of such policy if the applicant pharmacy indicates a desire to be so recognized and meets all the applicable terms and conditions of the policy contract.

     (3) Any pharmacy filling prescriptions under this section agrees to provide pharmaceutical services under the same terms, including administrative, financial, and professional conditions, as those provided by the designated pharmacy.

 

     NEW SECTION.  Sec. 5.  A new section is added to chapter 48.46 RCW to read as follows:

     (1) Each health maintenance agreement issued or renewed after November 1, 1992, that provides for payment of all or a portion of prescription costs, or reimbursement thereof, may not limit purchase of prescription medicines to a designated pharmacy nor provide for the payment of additional fees or deductibles by the covered pharmacy patient as a condition of obtaining prescription benefits from a pharmacy other than a designated pharmacy.

     (2) The policy may not prohibit a qualified provider of pharmacy services from becoming a designated provider under the provisions of such policy if the applicant pharmacy indicates a desire to be so recognized and meets all the applicable terms and conditions of the policy contract.

     (3) Any pharmacy filling prescriptions under this section agrees to provide pharmaceutical services under the same terms, including administrative, financial, and professional conditions, as those provided by the designated pharmacy.

     (4) This section does not apply to health maintenance organizations in which all pharmaceutical services are provided by employees of the health maintenance organization.

 

     NEW SECTION.  Sec. 6.  A new section is added to chapter 41.05 RCW to read as follows:

     (1) Each health plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is established or renewed after November 1, 1992, that provides for payment of all or a portion of prescription costs, or reimbursement thereof, may not limit purchase of prescription medicines to a designated pharmacy nor provide for the payment of additional fees or deductibles by the covered pharmacy patient as a condition of obtaining prescription benefits from a pharmacy other than a designated pharmacy.

     (2) The policy may not prohibit a qualified provider of pharmacy services from becoming a designated provider under the provisions of such policy if the applicant pharmacy indicates a desire to be so recognized and meets all the applicable terms and conditions of the policy contract.

     (3) Any pharmacy filling prescriptions under this section agrees to provide pharmaceutical services under the same terms, including administrative, financial, and professional conditions, as those provided by the designated pharmacy.