[atlas:bill]

AN ACT Relating to contraceptive health services; adding a new section to chapter 48.43 RCW; adding a new section to chapter 48.41 RCW; adding a new section to chapter 48.36A RCW; adding a new section to chapter 74.09 RCW; adding a new section to chapter 41.05 RCW; adding a new section to chapter 70.47 RCW; and declaring an emergency.

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

NEW SECTION. Sec. 1. A new section is added to chapter 48.43 RCW to read as follows:

(1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.

(a) "Health carrier" includes: Insuring entities listed in RCW 48.43.005(17); the state health insurance pool operating under chapter 48.41 RCW; fraternal benefit societies under chapter 48.36A RCW; health plans operating under the health care authority under chapter 41.05 RCW; managed health care systems operating under the basic health plan under chapter 70.47 RCW; and managed health care systems contracting with the department of social and health services under chapter 74.09 RCW.

(b) "Health plan" has the same meaning as defined in RCW 48.43.005.

(c) "Outpatient contraceptive services" means services necessary for the effective use of contraception, including family planning consultations, examinations, procedures for inserting, removing, or dispensing prescription contraceptive methods, and laboratory services provided on an outpatient basis and related to the use of contraceptive methods, including natural family planning.

(d) "Prescription contraceptive drugs and devices" means all prescription contraceptive drugs and devices approved by the United States food and drug administration.

(2) Every health carrier offering, issuing, or renewing a health plan on or after July 1, 2001, that provides coverage for prescription drugs must provide coverage for all prescription contraceptive drugs and devices approved by the United States food and drug administration.

(3) Every health carrier offering, issuing, or renewing a health plan on or after July 1, 2001, that provides coverage for outpatient services must provide coverage for all outpatient contraceptive services.

(4) Health carriers may not impose upon enrollees receiving prescription contraceptive drugs and devices or outpatient contraceptive services any:

(a) Copayment, coinsurance payment, or fee that is not equally imposed upon all individuals in the same benefit category, class, coinsurance level, or copayment level, receiving benefits for prescription drugs and outpatient services; or

(b) Reduction in allowable reimbursement for prescription drug benefits and outpatient services.

(5) This section does not prohibit health carriers from:

(a) Using generic equivalent drugs approved by the United States food and drug administration, whenever medically appropriate. When a brand name drug is requested by an enrollee and a generic equivalent is medically appropriate, this section may not be construed to prohibit a health carrier from requiring the enrollee to pay a deductible, coinsurance, or copayment consistent with subsection (4) of this section, in addition to the difference of the cost of the brand name drug, less the maximum covered amount of the generic equivalent; or

(b) Excluding nonprescription drugs and devices, or using closed formularies. However, the formularies must include all prescription contraceptive drugs and devices approved by the United States food and drug administration.

(6) Nothing in this section requires coverage for:

(a) Prescription contraceptive drugs and devices in any contract, policy, or health plan that does not otherwise provide coverage for prescription drugs; or

(b) Outpatient contraceptive services in any contract, policy, or health plan that does not otherwise provide coverage for outpatient services.

NEW SECTION. Sec. 2. A new section is added to chapter 48.41 RCW to read as follows:

Health plans offered or issued under this chapter by the state health insurance pool providing coverage for prescription contraceptive drugs and devices or outpatient contraceptive services are subject to the provisions of section 1 of this act.

NEW SECTION. Sec. 3. A new section is added to chapter 48.36A RCW to read as follows:

Benefit contracts offered or issued under this chapter providing coverage for prescription contraceptive drugs and devices or outpatient contraceptive services are subject to the provisions of section 1 of this act.

NEW SECTION. Sec. 4. A new section is added to chapter 74.09 RCW to read as follows:

Managed health care systems providing coverage for prescription contraceptive drugs and devices or outpatient contraceptive services under this chapter are subject to the provisions of section 1 of this act.

NEW SECTION. Sec. 5. A new section is added to chapter 41.05 RCW to read as follows:

Health plans offered or issued under this chapter providing coverage for prescription contraceptive drugs and devices or outpatient contraceptive services are subject to the provisions of section 1 of this act.

NEW SECTION. Sec. 6. A new section is added to chapter 70.47 RCW to read as follows:

NEW SECTION. Sec. 7. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION. Sec. 8. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately.