5441-S.E AMH HARR SILV 067

ESSB 5441 - H AMD TO HCW COMM AMD (H-2482.1/15) 434

By Representative Harris

ADOPTED 04/14/2015

    On page 1, beginning on line 15 of the striking amendment, after "(b)" strike all material through "dispensed" on line 29 and insert "The health benefit plan shall adjust the enrollee cost-sharing for a prescription drug subject to coinsurance that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications.

    (c) The health benefit plan shall adjust the enrollee cost-sharing for a prescription drug with a copayment that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications by:

    (i) Discounting the copayment rate by fifty percent;

    (ii) Discounting the copayment rate based on fifteen-day increments; or

    (iii) Any other method that meets the intent of this section and is approved by the office of the insurance commissioner"

    On page 2, beginning on line 8 of the striking amendment, after "(a)" strike all material through "(b)" on line 13

    Renumber the remaining subsection consecutively and correct any internal references accordingly.

    On page 2, beginning on line 32 of the striking amendment, after "(b)" strike all material through "dispensed" on page 3, line 7 and insert "The health benefit plan shall adjust the enrollee cost-sharing for a prescription drug subject to coinsurance that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications.

    (c) The health benefit plan shall adjust the enrollee cost-sharing for a prescription drug with a copayment that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications by:

    (i) Discounting the copayment rate by fifty percent;

    (ii) Discounting the copayment rate based on fifteen-day increments; or

    (iii) Any other method that meets the intent of this section and is approved by the office of the insurance commissioner"

    On page 3, beginning on line 20 of the striking amendment, after "(a)" strike all material through "(b)" on line 25

    Renumber the remaining subsection consecutively and correct any internal references accordingly.

EFFECT:   Removes the provisions of the striking amendment related to cost-sharing.

Requires health benefit plans (including plans offered to public employees) to adjust cost-sharing for a drug subject to coinsurance or with a copayment that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications.  Permits health benefit plans to meet the adjusted copayment requirement by:  (1) discounting the copayment rate by 50 percent; (2) discounting the copayment rate based on 15-day increments; or (3) any other method that meets the intent of the law and that is approved by the Office of the Insurance Commissioner.

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