Text: SF00451 Text: SF00453 Text: SF00400 - SF00499 Text: SF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 SENATE FILE 452
1 2
1 3 AN ACT
1 4 REQUIRING THE USE OF A UNIFORM PRESCRIPTION DRUG INFORMATION
1 5 CARD BY PROVIDERS OF THIRD-PARTY PAYMENT OR PREPAYMENT OF
1 6 PRESCRIPTION DRUG EXPENSES.
1 7
1 8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 9
1 10 Section 1. NEW SECTION. 514L.1 DEFINITIONS.
1 11 As used in this chapter, unless the context otherwise
1 12 requires:
1 13 1. "Guide" means the most recent national council for
1 14 prescription drug programs pharmacy identification card
1 15 implementation guide, or its successor.
1 16 2. "Prescription drug" means prescription drug as defined
1 17 in section 155A.3 and includes a device as defined in section
1 18 155A.3.
1 19 3. "Provider of third-party payment or prepayment of
1 20 prescription drug expenses" or "provider" means a provider of
1 21 an individual or group policy of accident or health insurance
1 22 or an individual or group hospital or health care service
1 23 contract issued pursuant to chapter 509, 514, or 514A, a
1 24 provider of a plan established pursuant to chapter 509A for
1 25 public employees, a provider of an individual or group health
1 26 maintenance organization contract issued and regulated under
1 27 chapter 514B, a provider of an organized delivery system
1 28 contract regulated under rules adopted by the director of
1 29 public health, a provider of a preferred provider contract
1 30 issued pursuant to chapter 514F, a provider of a self-insured
1 31 multiple employer welfare arrangement, and any other entity
1 32 providing health insurance or health benefits which provide
1 33 for payment or prepayment of prescription drug expenses
1 34 coverage subject to state insurance regulation.
1 35 Sec. 2. NEW SECTION. 514L.2 UNIFORM PRESCRIPTION DRUG
2 1 INFORMATION CARDS.
2 2 1. a. A provider of third-party payment or prepayment of
2 3 prescription drug expenses, including the provider's agents or
2 4 contractors and pharmacy benefits managers, that issues a card
2 5 or other technology for claims processing and an administrator
2 6 of the payor, excluding administrators of self-funded employer
2 7 sponsored health benefit plans qualified under the federal
2 8 Employee Retirement Income Security Act of 1974, shall issue
2 9 to its insureds a card or other technology containing uniform
2 10 prescription drug information. The commissioner of insurance
2 11 shall adopt rules for the uniform prescription drug
2 12 information card or technology applicable to those entities
2 13 subject to regulation by the commissioner of insurance. The
2 14 director of public health shall adopt rules for the uniform
2 15 prescription drug information card or technology applicable to
2 16 organized delivery systems. The rules shall require at least
2 17 both of the following regarding the card or technology:
2 18 (1) With respect to the information required, be
2 19 consistent with the guide, except that the address of the
2 20 pharmacy benefits manager shall not be required.
2 21 (2) With respect to the location of the information
2 22 required, be substantially consistent with the guide.
2 23 b. Any information on the card shall be formatted and
2 24 arranged in a manner that corresponds to the current content
2 25 and format required by the provider for processing of claims.
2 26 2. A new uniform prescription drug information card or
2 27 technology, as required pursuant to subsection 1, shall be
2 28 issued by a provider of third-party payment or prepayment or
2 29 the provider's agents or contractors or pharmacy benefits
2 30 managers upon enrollment and reissued upon any change in the
2 31 insured's coverage that impacts data contained on the card or
2 32 technology. The commissioner of insurance shall review the
2 33 national council for prescription drug programs implementation
2 34 guide or successor document on an ongoing basis to determine
2 35 changes, and shall modify or adopt rules as determined
3 1 appropriate.
3 2 3. The card or other technology may be used for any health
3 3 insurance or health benefits coverage and nothing in this
3 4 chapter shall require a provider to issue a separate card for
3 5 prescription drug coverage if the card or other technology can
3 6 accommodate the information necessary to process claims.
3 7 4. This chapter shall not apply to prescription drug
3 8 coverage provided through or in conjunction with any of the
3 9 following:
3 10 a. Accident-only or disability income insurance coverage.
3 11 b. Hospital confinement indemnity coverage.
3 12 c. Coverage issued as a supplement to liability insurance.
3 13 d. Basic hospital and medical-surgical expense coverage.
3 14 e. Liability insurance, including general liability
3 15 insurance and automobile liability insurance.
3 16 f. Workers' compensation or similar insurance.
3 17 g. Automobile medical payment insurance.
3 18 h. Credit only insurance.
3 19 i. Coverage for on-site medical clinic care.
3 20 j. Dental or vision coverage.
3 21 k. Benefits for long-term care, nursing home care, or
3 22 community-based care.
3 23 l. Short-term hospital, medical, or major medical
3 24 coverage.
3 25 m. Medicare supplemental as defined pursuant to 42 U.S.C.
3 26 } 1395ss(g)(1), coverage supplemental to the coverage provided
3 27 under 10 U.S.C. } 1071-1109, and similar coverage that is
3 28 supplemental to coverage under group health insurance coverage
3 29 as defined by the commissioner of insurance.
3 30 n. Any other similar limited benefits as defined by the
3 31 commissioner of insurance.
3 32 Sec. 3. NEW SECTION. 514L.3 APPLICATION – ENFORCEMENT.
3 33 1. A health insurance or health benefits policy or
3 34 contract issued and delivered, amended, or renewed on or after
3 35 July 1, 2003, shall comply with this chapter.
4 1 2. The commissioner of insurance shall enforce this
4 2 chapter and shall adopt rules necessary to implement this
4 3 chapter.
4 4
4 5
4 6
4 7 MARY E. KRAMER
4 8 President of the Senate
4 9
4 10
4 11
4 12 BRENT SIEGRIST
4 13 Speaker of the House
4 14
4 15 I hereby certify that this bill originated in the Senate and
4 16 is known as Senate File 452, Seventy-ninth General Assembly.
4 17
4 18
4 19
4 20 MICHAEL E. MARSHALL
4 21 Secretary of the Senate
4 22 Approved , 2001
4 23
4 24
4 25
4 26 THOMAS J. VILSACK
4 27 Governor
Text: SF00451 Text: SF00453 Text: SF00400 - SF00499 Text: SF Index Bills and Amendments: General Index Bill History: General Index
© 2001 Cornell College and League of Women Voters of Iowa
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