S-4001               _______________________________________________

                                                   SENATE BILL NO. 6374

                        _______________________________________________

State of Washington                               51st Legislature                              1990 Regular Session

By Senator Moore

Read first time 1/12/90 and referred to Committee on  Financial Institutions & Insurance.

AN ACT Relating to insurance coverage of dialysis medications; 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; and adding a new section to chapter 48.46 RCW.

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

NEW SECTION. Sec. 1.  A new section is added to chapter 48.20 RCW to read as follows:

          A disability insurance contract issued or renewed after January 1, 1991, that provides coverage for hospital or medical expenses shall provide coverage for over-the-counter medications used for the treatment of dialysis when the medications are deemed medically necessary by a holder of a license issued under chapter 18.71 RCW.  Coverage provided under this section must be at least equal to that coverage provided for prescription drugs and may incorporate the use of copayments and deductibles.  For purposes of this section, "over-the-counter medications" means drugs that can be obtained without a prescription but does not include vitamins.

NEW SECTION. Sec. 2.  A new section is added to chapter 48.21 RCW to read as follows:

          A group disability insurance contract entered into or renewed after January 1, 1991, that provides coverage for hospital or medical expenses shall provide coverage for over-the-counter medications used for the treatment of dialysis when the medications are deemed medically necessary by a holder of a license issued under chapter 18.71 RCW.  Coverage provided under this section must be at least equal to that coverage provided for prescription drugs and may incorporate the use of copayments and deductibles.  For purposes of this section, "over-the-counter medications" means drugs that can be obtained without a prescription but does not include vitamins.

NEW SECTION. Sec. 3.  A new section is added to chapter 48.44 RCW to read as follows:

          A group health care service contract entered into or renewed after January 1, 1991, that provides coverage for hospital or medical expenses shall provide coverage for over-the-counter medications used for the treatment of dialysis when the medications are deemed medically necessary by a holder of a license issued under chapter 18.71 RCW.  Coverage provided under this section must be at least equal to that coverage provided for prescription drugs and may incorporate the use of copayments and deductibles.  For purposes of this section, "over-the-counter medications" means drugs that can be obtained without a prescription but does not include vitamins.

NEW SECTION. Sec. 4.  A new section is added to chapter 48.46 RCW to read as follows:

          A health maintenance agreement entered into or renewed after January 1, 1991, that provides coverage for hospital or medical expenses shall provide coverage for over-the-counter medications used for the treatment of dialysis.  This coverage shall apply if the medications are deemed medically necessary by the medical director or his or her designee of the health maintenance organization and if provided by the health maintenance organization or upon the health maintenance organization's referral.  Over-the-counter medications shall be covered at the usual and customary rates for such medications, subject to contract provisions with respect to deductible amounts or copayments.  For purposes of this section, "over-the-counter medications" means drugs that can be obtained without a prescription but does not include vitamins.