House File 700 S-3141 Amend House File 700, as passed by the House, as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < Section 1. Section 155A.29, Code 2019, is amended to read 4 as follows: 5 155A.29 Prescription refills. 6 1. Except as specified in subsection 2 or 3 , a prescription 7 for any prescription drug or device which is not a controlled 8 substance shall not be filled or refilled more than eighteen 9 months after the date on which the prescription was issued and 10 a prescription which is authorized to be refilled shall not be 11 refilled more than twelve times. 12 2. A pharmacist may exercise professional judgment by 13 refilling a prescription without prescriber authorization if 14 all of the following are true: 15 a. The pharmacist is unable to contact the prescriber after 16 reasonable effort efforts . 17 b. Failure to refill the prescription might result in 18 an interruption of therapeutic regimen or create patient 19 suffering. 20 c. The pharmacist informs the patient or the patient’s 21 representative at the time of dispensing, and the practitioner 22 at the earliest convenience that prescriber reauthorization is 23 required. 24 3. d. Prescriptions may be refilled once pursuant to 25 subsection 2 for a period of time reasonably necessary for the 26 pharmacist to secure prescriber authorization. 27 3. a. In addition to the authorization for a pharmacist to 28 refill a prescription without prescriber authorization pursuant 29 to subsection 2, a pharmacist may exercise professional 30 judgment and refill a prescription for and dispense insulin 31 without prescriber authorization if all of the following 32 conditions are met: 33 (1) The pharmacy has a record of the patient’s expired 34 prescription. 35 -1- HF700.1649 (1) 88 pf/rh 1/ 3 #1.

(2) The pharmacist is unable to contact the prescriber after 1 reasonable efforts. 2 (3) The insulin is essential to the health of the patient 3 and the patient will be harmed if the insulin is not dispensed. 4 b. The pharmacist may dispense insulin pursuant to this 5 subsection in an amount not to exceed a thirty-day supply and 6 only once in a twelve-month period. 7 4. An authorization to refill a prescription drug order 8 shall be transmitted to a pharmacy by a prescriber or the 9 prescriber’s authorized agent pursuant to section 155A.27 , 10 except that prescription drug orders for controlled substances 11 shall be transmitted pursuant to section 124.308 , and, if not 12 transmitted directly by the practitioner, shall also include 13 the name and title of the practitioner’s agent completing the 14 transmission. 15 Sec. 2. NEW SECTION . 514C.18A Insulin coverage. 16 1. Notwithstanding the uniformity of treatment requirements 17 of section 514C.6, a policy or contract providing for 18 third-party payment or prepayment of insulin when prescribed 19 by a practitioner as defined in section 155A.3, shall provide 20 coverage for insulin dispensed without authorization pursuant 21 to section 155A.29, subsection 3, for an amount not to exceed a 22 thirty-day supply and only once in a twelve-month period. 23 2. a. This section applies to the following classes of 24 third-party payment provider contracts or policies delivered, 25 issued for delivery, continued, or renewed in this state on or 26 after July 1, 2019: 27 (1) Individual or group accident and sickness insurance 28 providing coverage on an expense-incurred basis. 29 (2) An individual or group hospital or medical service 30 contract issued pursuant to chapter 509, 514, or 514A. 31 (3) An individual or group health maintenance organization 32 contract regulated under chapter 514B. 33 (4) Any other entity engaged in the business of insurance, 34 risk transfer, or risk retention, which is subject to the 35 -2- HF700.1649 (1) 88 pf/rh 2/ 3

jurisdiction of the commissioner. 1 (5) A plan established pursuant to chapter 509A for public 2 employees. 3 b. This section shall not apply to accident-only, 4 specified disease, short-term hospital or medical, hospital 5 confinement indemnity, credit, dental, vision, Medicare 6 supplement, long-term care, basic hospital and medical-surgical 7 expense coverage as defined by the commissioner, disability 8 income insurance coverage, coverage issued as a supplement 9 to liability insurance, workers’ compensation or similar 10 insurance, or automobile medical payment insurance. > 11 2. Title page, by striking lines 1 and 2 and inserting 12 < An Act relating to the dispensing of insulin in emergency 13 situations, and providing for insurance coverage. > 14 ______________________________ THOMAS A. GREENE -3- HF700.1649 (1) 88 pf/rh 3/ 3 #2.