H-1719.2 _______________________________________________
SUBSTITUTE HOUSE BILL 1069
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State of Washington 52nd Legislature 1991 Regular Session
By House Committee on Health Care (originally sponsored by Representatives Braddock, Leonard, Prentice, Jones, Pruitt, Riley, Wineberry, Franklin, Jacobsen, Roland, H. Myers, Bowman, Inslee, Morris and Spanel).
Read first time February 25, 1991.
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:
Each disability insurance policy issued or renewed after January 1, 1992, that provides for payment of all or a portion of prescription medicine costs, or reimbursement therefor, may not limit purchase of prescription medicines to a designated pharmacy. The policy may not require the pharmacy patient to make a different or variable copayment or contribution, whether figured as a fixed dollar amount or a percentage of the cost, based on where or from whom the prescription medicines are purchased. This section does not prohibit any third-party payor of pharmaceutical services, who provides for reimbursement to the pharmacy patient or payment on his or her behalf, from limiting the amount reimbursed for the cost of prescription drugs to the cost of identical prescription drugs available through a designated pharmacy. For the purpose of this section, each third-party payor of pharmaceutical services shall identify as a part of the third-party agreement or contract the designated pharmacy that will be used as the baseline comparison.
NEW SECTION. Sec. 3. A new section is added to chapter 48.21 RCW to read as follows:
Each group disability insurance policy issued or renewed after January 1, 1992, that provides for payment of all or a portion of prescription medicine costs, or reimbursement therefor, may not limit purchase of prescription medicines to a designated pharmacy. The policy may not require the pharmacy patient to make a different or variable copayment or contribution, whether figured as a fixed dollar amount or a percentage of the cost, based on where or from whom the prescription medicines are purchased. This section does not prohibit any third-party payor of pharmaceutical services, who provides for reimbursement to the pharmacy patient or payment on his or her behalf, from limiting the amount reimbursed for the cost of prescription drugs to the cost of identical prescription drugs available through a designated pharmacy. For the purpose of this section, each third-party payor of pharmaceutical services shall identify as a part of the third-party agreement or contract the designated pharmacy that will be used as the baseline comparison.
NEW SECTION. Sec. 4. A new section is added to chapter 48.44 RCW to read as follows:
Each health care service contract issued or renewed after January 1, 1992, that provides for payment of all or a portion of prescription medicine costs, or reimbursement therefor, may not limit purchase of prescription medicines to a designated pharmacy. The contract may not require the pharmacy patient to make a different or variable copayment or contribution, whether figured as a fixed dollar amount or a percentage of the cost, based on where or from whom the prescription medicines are purchased. This section does not prohibit any third-party payor of pharmaceutical services, who provides for reimbursement to the pharmacy patient or payment on his or her behalf, from limiting the amount reimbursed for the cost of prescription drugs to the cost of identical prescription drugs available through a designated pharmacy. For the purpose of this section, each third-party payor of pharmaceutical services shall identify as a part of the third-party agreement or contract the designated pharmacy that will be used as the baseline comparison.
NEW SECTION. Sec. 5. A new section is added to chapter 48.46 RCW to read as follows:
Each health maintenance agreement issued or renewed after January 1, 1992, that provides for payment of all or a portion of prescription medicine costs, or reimbursement therefor, may not limit purchase of prescription medicines to a designated pharmacy. The policy may not require the pharmacy patient to make a different or variable copayment or contribution, whether figured as a fixed dollar amount or a percentage of the cost, based on where or from whom the prescription medicines are purchased. This section does not prohibit any third-party payor of pharmaceutical services, who provides for reimbursement to the pharmacy patient or payment on his or her behalf, from limiting the amount reimbursed for the cost of prescription drugs to the cost of identical prescription drugs available through a designated pharmacy. For the purposes of this section, each third-party payor of pharmaceutical services shall identify as a part of the third-party agreement or contract the designated pharmacy that will be used as the baseline comparison. 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:
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 January 1, 1992, that provides for payment of all or a portion of prescription medicine costs, or reimbursement therefor, may not limit purchase of prescription medicines to a designated pharmacy. The plan may not require the pharmacy patient to make a different or variable copayment or contribution, whether figured as a fixed dollar amount or a percentage of the cost, based on where or from whom the prescription medicines are purchased. This section does not prohibit any health plan that provides for reimbursement to the pharmacy patient or payment on his or her behalf, from limiting the amount reimbursed for the cost of prescription drugs to the cost of identical prescription drugs available through a designated pharmacy. For the purpose of this section, each health plan shall identify as a part of the health plan the designated pharmacy that will be used as the baseline comparison.