S-3745.1 _______________________________________________
SENATE BILL 6119
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State of Washington 54th Legislature 1996 Regular Session
By Senator Quigley
Read first time 01/08/96. Referred to Committee on Health & Long‑Term Care.
AN ACT Relating to insurance coverage for prescription medicine; 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; and creating new sections.
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' freedom 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 July 1, 1996, that provides for payment of all or a portion of prescription costs, or reimbursement of prescription costs, 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 the policy if the applicant pharmacy indicates a desire to be recognized as a designated provider and meets all the applicable terms and conditions of the policy contract.
(3) All qualified providers of pharmacy services shall be subject to the same terms and conditions for becoming a designated provider.
(4) A 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 July 1, 1996, that provides for payment of all or a portion of prescription costs, or reimbursement of prescription costs, 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 the policy if the applicant pharmacy indicates a desire to be recognized as a designated provider and meets all the applicable terms and conditions of the policy contract.
(3) All qualified providers of pharmacy services shall be subject to the same terms and conditions for becoming a designated provider.
(4) A 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 July 1, 1996, that provides for payment of all or a portion of prescription costs, or reimbursement of prescription costs, 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 the policy if the applicant pharmacy indicates a desire to be recognized as a designated provider and meets all the applicable terms and conditions of the policy contract.
(3) All qualified providers of pharmacy services shall be subject to the same terms and conditions for becoming a designated provider.
(4) A 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 July 1, 1996, that provides for payment of all or a portion of prescription costs, or reimbursement of prescription costs, 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 the policy if the applicant pharmacy indicates a desire to be recognized as a designated provider and meets all the applicable terms and conditions of the policy contract.
(3) All qualified providers of pharmacy services shall be subject to the same terms and conditions for becoming a designated provider.
(4) A 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. 6. (1) All carriers, as defined in RCW 48.43.005, who violate this act or any rule adopted under this act shall pay a civil penalty of not less than one thousand dollars nor more than fifty thousand dollars for each violation. The attorney general shall bring an action in superior court to enforce the provisions of this act.
(2) Any person may bring a civil action against any carrier to recover damages suffered as the result of a violation of this act or of a rule adopted under this act. Proof of a violation constitutes prima facie evidence of damages. The court shall award treble the amount of damages.
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